선천성 갑상선기능저하증과 가성부갑상선기능저하증을 동반한 환자의 전신마취 하 치과치료
General Anesthesia for Dental Treatment in the Congenital Hypothyroidism and Psuedohypoparathyroidism
서광석, 신터전, 김현정, 장주혜,
소속 상세정보
서광석 ( Seo Kwang-Suk ) - 서울대학교 치의학대학원 치과마취과학교실
신터전 ( Shin Teo-Jeon ) - 서울대학교 치의학대학원 소아치과학교실
김현정 ( Kim Hyun-Jeong ) - 서울대학교 치의학대학원 치과마취과학교실
장주혜 ( Chang Ju-Hea ) - 서울대학교 치과병원 장애인구강진료실
KMID : 0980220130130030139
Abstract
The patient who has congenital hypothyroidism and pseudohypoparathyroidism could have mental retardation even though adequate hormone treatment and cannot endure conventional dental treatment. In this case, general anesthesia is selected to administer effective dental treatment. But, there could be symptoms such as anemia, neuropathy, associated pituitary or adrenal hypofunction, cardiac failure even in euthyroid state. And, bradycardia, mental dullness, hypothermia, slow reflexes can appear in case of inadequate thyroid hormone replacement. Especially, macroglosssia, slow drug metabolism, exaggerated responses to anesthetic agents and decreased ventilatory responses could be problem during general anesthesia. The presentation of hypoparathyroidism also varies depending on the chronicity of the result of hypocalcemia. Muscle spasms/tetany, paresthesias, and seizures may occur in an acute onset. Chronic hypocalcaemia causes fatigue, muscle cramps, lethargy, personality changes, and cerebration defects.
키워드
Congenital Hypothyroidism; Dental Treatment; Disabled Patient; General Anesthesia; Psuedohypoparathyroidism
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