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Dental treatment of a patient with long QT syndrome under moderate sedation with target-controlled infusion of propofol

Journal of Dental Anesthesia and Pain Medicine 2015³â 15±Ç 3È£ p.161 ~ 165
±è°æÁø, ÇöÈ«±Ù, ±è¿µÀç, ±èÁ¤¿í, ½ÅÅÍÀü,
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±è°æÁø ( Kim Kyung-Jin ) - Seoul National University School of Dentistry Department of Pediatric Dentistry
ÇöÈ«±Ù ( Hyun Hong-Keun ) - Seoul National University School of Dentistry Department of Pediatric Dentistry
±è¿µÀç ( Kim Young-Jae ) - Seoul National University School of Dentistry Department of Pediatric Dentistry
±èÁ¤¿í ( Kim Jung-Wook ) - Seoul National University School of Dentistry Department of Pediatric Dentistry
½ÅÅÍÀü ( Shin Teo-Jeon ) - Seoul National University School of Dentistry Department of Pediatric Dentistry

Abstract


Long QT syndrome (LQTs) is a rare congenital disorder of the heart's electrical activity. Patients with LQTs are at increased risk of developing fatal ventricular arrhythmias. Elevated levels of sympathetic stimulation can exacerbate this risk. Successful behavior management is indispensable in the treatment of patients with LQTs. However, many drugs involved in pharmacologic behavior management are known to adversely affect the QT interval. Therefore, careful selection of a sedative drug is essential in avoiding such incidences. A 10-year-old boy with a known diagnosis of LQTs required restorative treatment due to dental caries at the permanent molar. He required sedation since treatment was painful and dental phobia can trigger sympathetic stimulation, creating a dangerous situation for patients with LQTs. Therefore, the treatment was performed over two sessions under moderate sedation involving propofol combined with nitrous oxide. Restorative treatment was successful without any complications under sedation with a target-controlled infusion (TCI) of propofol. There was no significant QT prolongation during pulpal treatment. Propofol TCI may be a good candidate for sedation in patients with LQTs.

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Long QT syndrome; Moderate sedation; Propofol

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