補綴処置中に意識混濁を認めた高齢歯科外来患者の1症例

概要

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A 71-year-old male, dental aged outpatient with consciousness disorder showed a decrease of in blood pressure and ST depression in the electrocardiogram (ECG) while muscle trimming. He has diabetes and hypertension that have been controlled by an other hospital. These was being abnormal during dental treatment and minor oral surgery. We received an emergency call from the dentist of the patient. We arrived with in 90 seconds and found him lying and moaning, without vomiting or dyspnea. It was difficult to establish the radial arterial pulse of carotid arterial pulse, the blood pressure was 77 mmHg systolic, 62 mmHg diastolic. The heart rate was a regular sinus rhythm at 52 beats/min; the respiratory rate was 10 cycles/min; body temperature 36.2℃. The ECG finding would have been ST depression, and we started nitroglycerin infusion (1.2/μg/kg/min), as these were the possibility of an angina attack or cerebrovascular disorder. The patient was sent to a neurological surgery hospital. He had angina spasms 4-days after admission and was admitted at a cardiovascular hospital. A close, medical examination led to a final diagnosis of medium vasospastic angina. This episode was first angina attack for this patient. We conclude that dental treatment of aged outpatients has to be careful and needs to be administered carefully.
北海道医療大学の論文
1996-06-30