三尖弁閉鎖症を合併した歯科治療患者の鎮静管理経験 : 近赤外線酸素モニターの応用

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We experienced intravenous sedation management of a patient who had the tricuspid atresia (TA, 1b) and also investigated the change in intracerebral oxygen environment during intravenous sedation using a near-infrared oxygen monitor (NIRO). A 21-year-old male (height 160cm, weight 61kg) patient, diagnosed with horizontal eruption of wisdom teeth in lower jaw left-hand side, was scheduled for extraction under intravenous sedation. He was diagnosed with tricuspid atresia just after birth. Balloon atrioseptostomy (BAS) was done at 24 days, Blalock-Taussing shunt operation at 4 years old, and Gleen operation at 2 years old. He had cyanosis and clubbed fingers, SPO_2 by pulse oximetry showed 82 to 85% oxygen saturation with room air in everyday life. The ampicillin natrium (2g) was administered 60 minutes before the start of anesthesia intravenously. Intravenous sedation was maintained with 41/min oxygen, midazolam (2.0mg) and propofol (0.6〜1.2μg/ml) to relieve anxiety and procedural stress leading to possible changes in his hemodynamic state. His hemodynamics were almost stable. The oxygenation index (TOI) by NIRO was changed 68.8 to 76.2% within normal range and may not have been a clinical problem. Tricuspid atresia is a disease with a poor prognosis. So we have needed a grasp of sick reserve force and careful caution for the complications in anesthetization management. Moreover, it was suggested that NIRO is effective for safe perioperative management in intravenous sedation management.
岩手医科大学歯学会の論文
2009-08-20

三尖弁閉鎖症を合併した歯科治療患者の鎮静管理経験 : 近赤外線酸素モニターの応用

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