진행성 치성 감염병소에서 부적절한 진정요법과 국소마취 시행하 절개 배농술에 따른 과환기증
Hyperventilation due to Incision & Drainage under Inadequate Psychosedation & Local Anesthesia in Advanced Odontogenic Infectious Lesion
오지현, 손정석, 유재하, 김종배,
소속 상세정보
오지현 ( Oh Ji-Hyeon ) - 연세대학교 원주세브란스기독병원 치과학교실
손정석 ( Son Jeong-Seog ) - 연세대학교 원주세브란스기독병원 치과학교실
유재하 ( Yoo Jae-Ha ) - 연세대학교 원주세브란스기독병원 치과학교실
김종배 ( Kim Jong-Bae ) - 계명대학교 의과대학 치과학교실
KMID : 0980220140140010063
Abstract
Extension of advanced odontogenic infection from deep neck fascial spaces into the mediastinum is heralded by chest pain, dyspnea, fever, and radiographic demonstration of mediastinal widening. The critical care should be done in a team approach by multiple medical and dental departments, such as, oral & maxillofacial surgery, otolaryngology, anesthesiology, chest surgery, and infection medicine. Especially, fluid & drug therapy, adequate incision & drainage and systemic supportive psychosedation care are important. But, acute hyperventilation can be produced by several distinct causes: severe anxiety, respiratory alkalosis, increased blood catecholamine levels, and a decrease in the level of the ionized calcium in the blood. The orofacial fears about acute pain, trismus, dysphagia, swelling and oral surgical treatment lead to the severe anxiety and increased blood catecholamine level by stress. Therefore, the most dental patient should be cared gently as the stress reduction protocol. In spite of the care, hyperventilation was occurred during psychosedation and local anesthesia for incision and drainage of the masticatory fascial space abscess with deep neck infection & mediastinitis. We suggest that the dental patient with advanced odontogenic infection must be attention for the manifestation of hyperventilation, especially in the medically compromised conditions.
키워드
Hyperventilation; Incision & drainage; Local amesthesia; Odontogenic infection; Psychosedation
원문 및 링크아웃 정보
등재저널 정보