Dental treatment of a patient with long QT syndrome under moderate sedation with target-controlled infusion of propofol.
10.17245/jdapm.2015.15.3.161
- Author:
Kyung Jin KIM
1
;
Hong Keun HYUN
;
Young Jae KIM
;
Jung Wook KIM
;
Teo Jeon SHIN
Author Information
1. Department of Pediatric Dentistry and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea. snmc94@snu.ac.kr
- Publication Type:Case Report
- Keywords:
Long QT syndrome;
Moderate sedation;
Propofol
- MeSH:
Arrhythmias, Cardiac;
Child;
Congenital, Hereditary, and Neonatal Diseases and Abnormalities;
Conscious Sedation*;
Dental Anxiety;
Dental Caries;
Diagnosis;
Humans;
Incidence;
Long QT Syndrome*;
Male;
Molar;
Nitrous Oxide;
Propofol*
- From:Journal of Dental Anesthesia and Pain Medicine
2015;15(3):161-165
- CountryRepublic of Korea
- Language:English
-
Abstract:
Long QT syndrome (LQTs) is a rare congenital disorder of the heart's electrical activity. Patients with LQTs are at increased risk of developing fatal ventricular arrhythmias. Elevated levels of sympathetic stimulation can exacerbate this risk. Successful behavior management is indispensable in the treatment of patients with LQTs. However, many drugs involved in pharmacologic behavior management are known to adversely affect the QT interval. Therefore, careful selection of a sedative drug is essential in avoiding such incidences. A 10-year-old boy with a known diagnosis of LQTs required restorative treatment due to dental caries at the permanent molar. He required sedation since treatment was painful and dental phobia can trigger sympathetic stimulation, creating a dangerous situation for patients with LQTs. Therefore, the treatment was performed over two sessions under moderate sedation involving propofol combined with nitrous oxide. Restorative treatment was successful without any complications under sedation with a target-controlled infusion (TCI) of propofol. There was no significant QT prolongation during pulpal treatment. Propofol TCI may be a good candidate for sedation in patients with LQTs.
