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Sevoflurane Insufflation Sedation for the Dental Treatment of a Patient with Pulmonary Arterial Hypertension : A Case Report

  • Journal of the Korean academy of pediatric dentistry
  • Abbr : J Korean Acad Pediatr Dent
  • 2015, 42(1), pp.75-79
  • DOI : 10.5933/JKAPD.2015.42.1.75
  • Publisher : The Korean Academy Of Pediatric Dentistry
  • Research Area : Medicine and Pharmacy > Dentistry

지성인 1 kim seung oh 2

1단국대학교 치과대학 소아치과학교실
2단국대학교

Accredited

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.

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