Sevoflurane Insufflation Sedation for the Dental Treatment of a Patient with Pulmonary Arterial Hypertension : A Case Report
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Pulmonary arterial hypertension (PAH) is a common complication of Congenital heart defects (CHD) withleft-to-right shunts, and PAH with increased pulmonary vascular resistance (PVR) is associated with considerablemorbidity and mortality. General anesthesia (GA) can be life-threatening in patients with PAH, becausethe positive pressure ventilation during GA increases pulmonary arterial pressure and decreases pulmonaryblood flow. This may also lead to hypoxia. Therefore, spontaneous ventilation may be safer than positive pressureventilation in patients with PAH. A five-year-old male child, weighing 11 kg, with medical history showing a total correction of Tetralogy ofFallot (TOF) in 2009 and ongoing treatment with hypertension (HTN) medicine since 2007, visited theDankook University Dental Hospital. He had multiple dental caries, and the treatment was completed undersevoflurane insufflation sedation via nasal cannula. The patient remained sedated throughout the operationwhile maintaining normal vital signs and spontaneous respiration. In conclusion, sevoflurane insufflation sedation may be a safer alternative to GA for the dental treatment ofpatients with PAH.
Abstract
Pulmonary arterial hypertension (PAH) is a common complication of Congenital heart defects (CHD) withleft-to-right shunts, and PAH with increased pulmonary vascular resistance (PVR) is associated with considerablemorbidity and mortality. General anesthesia (GA) can be life-threatening in patients with PAH, becausethe positive pressure ventilation during GA increases pulmonary arterial pressure and decreases pulmonaryblood flow. This may also lead to hypoxia. Therefore, spontaneous ventilation may be safer than positive pressureventilation in patients with PAH. A five-year-old male child, weighing 11 kg, with medical history showing a total correction of Tetralogy ofFallot (TOF) in 2009 and ongoing treatment with hypertension (HTN) medicine since 2007, visited theDankook University Dental Hospital. He had multiple dental caries, and the treatment was completed undersevoflurane insufflation sedation via nasal cannula. The patient remained sedated throughout the operationwhile maintaining normal vital signs and spontaneous respiration. In conclusion, sevoflurane insufflation sedation may be a safer alternative to GA for the dental treatment ofpatients with PAH.
참고문헌 (21)
- Levine DJ, "Diagnosis and management of pulmonary arterial hypertension: implications for respiratory care", Respir Care, 51, pp.368~381 (2006)
- Friesen RH, "Anesthetic management of children with pulmonary arterial hypertension", Paediatr Anaesth, 18, pp.208~216 (2008)
- Hill NS, "Postoperative pulmonary hypertension: etiology and treatment of a dangerous complication", Respir Care, 54, pp.958~968 (2009)
- Pritts CD, "Anesthesia for patients with pulmonary hypertension", Curr Opin Anaesthesiol, 23, pp.411~416 (2010)
- Kim SO, "Deep sedation with sevoflurane insufflated via a nasal cannula in uncooperative child undergoing the repair of dental injury", Am J Emerg Med, 31, pp.894e1~894e3 (2013)
- Kim SO, "Deep sedation with sevoflurane inhalation via a nasal hood for brief procedure in pediatric patients", Pediatr Emerg Care, 29, pp.926~928 (2013)
- Sury MRJ, "Sevoflurane sedation in infants undergoing MRI: a preliminary report", Paediatr Anaesth, 15, pp.16~22 (2005)
- Yu L, "Comparison of effective inspired concentration of sevoflurane in preterm infants with different postconceptual ages", Paediatr Anaesth, 21, pp.148~152 (2011)
- Fischer LG, "Management of pulmonary hypertension: physiological and pharmacological considerations for anesthesiologists", Anesth Analg, 96, pp.1603~1616 (2003)
- Carmosino MJ, "Perioperative complications in children with pulmonary hypertension under going noncardiac surgery or cardiac catheterization", Anesth Analg, 104, pp.521~527 (2007)
- Flick RP, "Perioperative cardiac arrests in children between 1988 and 2005 at a tertiary referral center", Anesthesiology, 106, pp.226~237 (2007)
- Miller RD, "Miller’s anesthesia", pp.361~392 (2010), Churchill Livingstone Inc
- Forrest P, "Anaesthesia and right ventricular failure", Anaesth Intensive Care, 37, pp.370~385 (2009)
- Höhn L, "Circulatory failure after anesthesia induction in a patient with severe primary pulmonary hypertension", Anesthesiology, 91, pp.1943~1945 (1999)
- Höhn L, "Extreme pulmonary hypertension and anesthesia induction", Anesthesiology, 93, pp.903~904 (2000)
- De Sanctis Briggs V, "Magnetic resonance imaging under sedation in newborns and infants: a study of 640 cases using sevoflurane", Paediatr Anaesth, 15, pp.9~15 (2005)
- Smith I, "Sevoflurane - a long-awaited volatile anaesthetic", Br J Anaesth, 76, pp.435~445 (1996)
- "Conscious sedation with sevoflurane", Anaesthesia tutorial of the week, 188~ (2010)
- Friesen RH, "Changes in carbon dioxide tension and oxygen saturation during deep sedation for paediatric cardiac catheterization", Paediatr Anaesth, 6, pp.15~20 (1996)
- Friesen RH, "End-tidal PCO2 monitoring via nasal cannulae in pediatric patients: accuracy and sources of error", J Clin Monit, 12, pp.155~159 (1996)
- Motas D, "Depth of consciousness and deep sedation attained in children as administered by nonanaesthesiologists in a children’s hospital", Pediatr Anesth, 14, pp.256~260 (2004)