1.Oral surgery under local anesthesia with dexmedetomidine sedation in a morbidly obese patient with aortic dissection.
Mika SETO ; Michitaka MATSUDA ; Kyoichi NARIHIRA ; Toshihiro KIKUTA
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2016;42(3):162-165
We report a case of a morbidly obese man with an aortic aneurysm, in whom dental surgery was performed before elective cardiac surgery. His aortic aneurysm required emergency surgery. However, because of his morbid obesity, elective cardiac surgery was planned. Considering the high risk of infective endocarditis, dental surgery was required. Our patient was at a high risk of aortic rupture caused by hypertension and breathing difficulty in the supine position. Dexmedetomidine (DEX) is an anti-anxiety, sedative, and analgesic medicine that can stabilize circulatory dynamics and minimize blood pressure fluctuations. We administered intravenous DEX for sedation of the patient in Fowler's position. In conclusion, our understanding of the risk factors of DEX enabled us to perform safe invasive oral treatment.
Anesthesia, Local*
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Anesthetics, Local
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Aortic Aneurysm
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Aortic Rupture
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Blood Pressure
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Dexmedetomidine*
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Emergencies
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Endocarditis
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Humans
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Hypertension
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Obesity, Morbid
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Oral Surgical Procedures
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Respiration
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Risk Factors
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Supine Position
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Surgery, Oral*
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Thoracic Surgery