知的障害を伴った Glenn 術後患者の静脈内鎮静法の経験

Translated title of the contribution: Intravenous Sedation in a Child with Intellectual Disability and a History of a Glenn Procedure

Hitomi Ujita, Yuka Wakasugi, Mai Nakano, Yukiko Nishioka, Hitoshi Higuchi, Shigeru Maeda, Takuya Miyawaki

Research output: Contribution to journalArticlepeer-review

Abstract

We performed intravenous sedation for the extraction of deciduous teeth in a 9-year-old boy with hypoplastic left heart syndrome(HLHS)and intellectual disability who had previously undergone a Glenn procedure. He had previously been diagnosed as having HLHS and had undergone pulmonary artery banding, a Norwood procedure and a Glenn procedure. However, he had not yet undergone a Fontan operation because of the poor growth of the pulmonary vascular bed. After the Glenn procedure, a shunt that allowed the mixing of venous blood from the inferior vena cava and arterial blood from the pulmonary vein was left in place, and pulse oximetry showed an SpO2 of 85% oxygen saturation with the provision of 1 l/min of oxygen in everyday life. Furthermore, he had severe intellectual disability and could hardly communicate. He had experienced episodes of cyanosis because of agitation and crying during rehabilitation. To prevent cyanosis as a result of agitation and crying, we decided to extract the deciduous teeth under anesthesia management. Intravenous sedation was selected because of the minimally invasive and short-term surgery. Intravenous sedation was induced and maintained using ketamine to avoid circulatory and respiratory suppression. Cyanosis did not occur, and no significant changes in the patient's vital signs were observed throughout the period of intravenous sedation. Although ketamine increases airway secretion, no problems with airway management occurred in the present case. Intravenous sedation with ketamine is likely to be a safe and effective management for patients who have undergone a Glenn procedure.

Translated title of the contributionIntravenous Sedation in a Child with Intellectual Disability and a History of a Glenn Procedure
Original languageJapanese
Pages (from-to)138-140
Number of pages3
JournalJournal of Japanese Dental Society of Anesthesiology
Volume48
Issue number4
DOIs
Publication statusPublished - 2020

ASJC Scopus subject areas

  • Dentistry(all)
  • Anesthesiology and Pain Medicine

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