Airway Obstruction and Respiratory Distress Owing to Sedation by use of Chloral Hydrate & Ketamine Before Extraction of the Mesiodens in Patient with Bronchial Asthma & Tonsillar Hyperplasia -A Case Report-

기관지 천식과 편도 증식증 환자에서 상악 정중부 과잉치 발치 전 포크랄과 케타민 투여 진정요법 시 발생된 기도폐쇄와 호흡장애 -증례 보고-

  • Choi, Young-Su (Department of Oral and Maxillofacial Surgery, National Health Insurance Corporation Ilsan Hospital) ;
  • Kang, Sang-Hoon (Department of Oral and Maxillofacial Surgery, National Health Insurance Corporation Ilsan Hospital) ;
  • Kim, Moon-Key (Department of Oral and Maxillofacial Surgery, National Health Insurance Corporation Ilsan Hospital) ;
  • Lee, Chun-Ui (Department of Oral and maxillofacial Surgery, College of Dentistry, Yonsei University (Wonju Christian Hospital)) ;
  • Yoo, Jae-Ha (Department of Oral and maxillofacial Surgery, College of Dentistry, Yonsei University (Wonju Christian Hospital))
  • 최영수 (국민건강보험공단일산병원 구강악안면외과) ;
  • 강상훈 (국민건강보험공단일산병원 구강악안면외과) ;
  • 김문기 (국민건강보험공단일산병원 구강악안면외과) ;
  • 이천의 (연세대학교 치과대학 구강악안면외과학교실(원주기독병원)) ;
  • 유재하 (연세대학교 치과대학 구강악안면외과학교실(원주기독병원))
  • Received : 2010.04.08
  • Accepted : 2010.06.20
  • Published : 2010.06.27

Abstract

The causes for airway obstruction include foreign body aspiration, congenital structural abnormalities of the airway, infection, etc. And the potential causes of acute respiratory distress contain many situations, like hyperventilation, vasodepressor syncope, asthma, etc. A major factor that leads to the exacerbation of respiratory disorders is undue stress, either physiologic or psychologic. Psychologic stress in dentistry is the primary factor in the exacerbation of preexisting medical problems. Adequate pretreatment medical and dental evaluation of the prospective patient can often prevent respiratory problems from developing. The dentist can modify patient management to minimize the risk of exacerbating these conditions. When dental anxiety is a major factor, the use of psychosedative procedures and other stress-reduction techniques should also be considered. This is the report of a children case of airway obstruction and respiratory distress owing to sedation complication by use of Chloral hydrate and Ketamine before extraction of the mesiodens in a patient with bronchial asthma and tonsillar hyperplasia. After these situations, the patient was consulted & referred to the department of Pediatrics and Otorhinolaryngology.

Keywords

References

  1. 강정완, 김수관, 김여갑, 김철홍, 김현정, 서광석 외 6인: 대한치과마취과학회편. 치과진료실에서의 응급처치. In: Malamed SF, Medical emergencies in the dental office, 제6판 역서. 서울, 대한나래출판사. 2009, 179-83.
  2. 김기령: 구개편도비대 및 선양 증식증이 아동의 발육상태 및 학업성적(지능지수)에 미치는 영향에 관한 임상 통계적 관찰. 대한이비인후과학회지 1964; 7:57-62
  3. 김동수: 마취과학 핵심분석. 서울, 군자출판사. 1993.23-49
  4. 김여갑, 강정완, 김동옥, 김명진, 김성민, 김수관 외 19인: 소아 구강악안면외과학, In: Leonard B, Pediatric oral and maxillofacial surgery 역서. 서울, 군자출판사. 2006, 87-112.
  5. 윤형배: 진정요법 - 치과 및 의과 환자관리 지침서. In: Malamed SF, Sedation, a guide to patient management 역서. 서울, 대한나래출판사. 2003, 89-102, 366-7, 481-514.
  6. 이광호, 김종운: 의학교육연수원 편 의학연수교육총서 제1집, 응급처치. 제7판. 서울, 서울대학교 출판부. 1994, 3-13, 62-67.
  7. 홍창의: 소아과학. 개정 3판. 서울, 대한교과서주식회사. 1987, 603-2.
  8. Fast TB, Martin MD, Ellis TM: Emergency preparedness: a survey of dental practitioners. J Am Dent Assoc 1986; 112: 499-501.
  9. Goodwin RD: Asthma and anxiety disorders. Adv psychosom Med 2003; 24: 51-71. https://doi.org/10.1159/000073780
  10. Haas DA, Harper DG: Ketamine: a review of its pharmacologic properties and use in ambulatory anesthesia. Anesth Prog 1992; 39: 61-6.
  11. Laskin DM: Conscious sedation in oral and maxillofacial surgery. CV Mosby 1981; 652-8.
  12. Little JW, Falace DA, Miller CS, Rhodus NL: Dental management of the medically compromised patient, Sixth ed. CV Mosby, 2002; 130-46.
  13. Mathew T: Effect of dental treatment on the lung function of children with asthma. J Am Dent Assoc 1998; 129: 1120-8. https://doi.org/10.14219/jada.archive.1998.0387
  14. Reich DL, Silvay G: Ketamine: an update on the first twenty-five years of clinical experience. Can J Anaesth 1989; 36: 186-91. https://doi.org/10.1007/BF03011442
  15. Steinbacher DM, Glick M: The dental patient with asthma: an update and oral health considerations. J Am Dent Assoc 2001; 132: 1229-39. https://doi.org/10.14219/jada.archive.2001.0365
  16. Sussman DR: A comparative evaluation of Ketamine anesthesia in children and adults. Anesthesiology 1974; 40 : 459-64. https://doi.org/10.1097/00000542-197405000-00012
  17. Talbot H: Adenoidetomy, technique and postoperative care. Laryngoscope 1965; 75: 12-7.
  18. Ulrik C, Frederiken J: Mortality and markers of risk of asthma death among 1,075 outpatients with asthma. Chest 1995; 108: 10-5. https://doi.org/10.1378/chest.108.1.10
  19. White PF, Way WL, Trevor AJ: Ketamine: its pharmacology and therapeutic uses. Anesthesiology 1982; 56: 119-24. https://doi.org/10.1097/00000542-198202000-00007