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알츠하이머병 환자의 외래전신마취 하 치과치료
Dental Treatment of a Patient with Alzheimer Disease under Ambulatory General Anesthesia

대한치과마취과학회지 2011년 11권 2호 p.146 ~ 152

김미선, 서광석, 김현정, 신터전, 장주혜,

소속 상세정보

김미선 ( Kim Mi-Seon ) - 서울대학교 치과병원 치과마취과
서광석 ( Seo Kwang-Suk ) - 서울대학교 치과병원 치과마취과
김현정 ( Kim Hyun-Jeong ) - 서울대학교 치과병원 치과마취과
신터전 ( Shin Teo-Jeon ) - 서울대학교 치과병원 소아치과
장주혜 ( Chang Ju-Hea ) - 서울대학교 치과병원 장애인구강진료실

KMID : 0980220110110020146

Abstract

Background: Elderly patients with progressive dementia including Alzheimer’s disease (AD) are more and more often scheduled to undergo general anesthesia for various pathologies including dental problem. But, there is high risk of deterioration of underlying mental diseases and other co-morbidities. So it is important to implement preventive strategies and take adequate measures to minimize negative perioperative events in these patients.

Methods: We reviewed the 17 cases of 11 patients with AD who underwent ambulatory general anesthesia for dental treatment at the clinic for the disabled in Seoul National University Dental Hospital.

Results: The mean age was 68 (57-81) years. All of them were diagnosed with AD and some had hypertsnsion, bronchiectasis, urinary incontinence. For anesthesia induction, 3 cases (1 patient) was needed physical restraint, but others showed good or moderate cooperation. Drugs used for anesthesia induction was thiopental (11 cases), propofol (3 cases) and sevoflurane (3 cases). All patients received nasotracheal intubation without difficulties. Mean total anesthetic time was 3 hour 44 min 60 min and staying time at PACU was 83 34 min. All the patients except one who showed hypertension discharged without any complication. There was no death or long term hospitalization because of severe complications.

Conclusions: If general anesthesia is needed, pertinent diagnostic tests and workup about other medical problems, and appropriate anesthetic planning are essential for safety.