Ozasa Hiroshi, Uchida Hiroshi, Toyota Kosaku, Sato Naoki, Muguruma Tomoko
Department of Anesthesia, Tottori Prefectural Central Hospital, Tottori 680-0901.
Masui. 2003 Jul;52(7):753-5.
General anesthesia for dental treatment in disabled patients may present particular problems, especially when it is done in a general hospital, compared with specialized dental hospitals.
We surveyed 24 patients who underwent dental treatment under general anesthesia in our institution during the last decade.
Electrocardiography or chest x-ray photography was not obtained in 8 patients owing to lack of patients' cooperation. Slow induction with sevoflurane was selected in 5 patients, because intravenous cannulae could not be placed owing to their rejection. Nasotracheal intubation was performed in all patients, but no difficulty in intubation was documented. As postoperative complications, we observed convulsion in one patient and muscle rigidity in another, but no critical troubles related to circulatory or respiratory status. In patients who were treated for more than ten teeth, we observed differences in age, body weight, duration of anesthesia, maximum concentration of sevoflurane administered during anesthesia, and use of postoperative analgesics compared with the other patients.
We found particular problems of anesthesia for disable patients undergoing dental treatment in a general hospital, and suggest that information on numbers of teeth to be treated is helpful.
与专业牙科医院相比，为残疾患者进行牙科治疗的全身麻醉可能会出现特殊问题，尤其是在综合医院进行时。
我们调查了过去十年间在我院接受全身麻醉下牙科治疗的24例患者。
8例患者因不配合未进行心电图检查或胸部X光摄影。5例患者因拒绝静脉置管而选择七氟醚慢诱导。所有患者均行鼻气管插管，但未记录到插管困难。术后并发症方面，我们观察到1例患者惊厥，另1例患者肌肉强直，但未出现与循环或呼吸状况相关的严重问题。与其他患者相比，接受十颗以上牙齿治疗的患者在年龄、体重、麻醉持续时间、麻醉期间使用的七氟醚最大浓度以及术后镇痛药使用方面存在差异。
我们发现综合医院中残疾患者牙科治疗的麻醉存在特殊问题，并建议了解待治疗牙齿数量的信息会有所帮助。
