Use of ADMS™ during sedation for dental treatment of an intellectually disabled patient: a case report
지성인, 김현정, 서광석, Yang Martin, 장주혜,
소속 상세정보
지성인 ( Chi Seong-In ) - Seoul National University Dental Hospital Department of Dental Anesthesiology
김현정 ( Kim Hyun-Jeong ) - Seoul National University Dental Hospital Department of Dental Anesthesiology
서광석 ( Seo Kwang-Suk ) - Seoul National University Dental Hospital Department of Dental Anesthesiology
( Yang Martin ) - Unimedics CO., LTD. Research Institute
장주혜 ( Chang Ju-Hea ) - Seoul National University Dental Hospital Special Care Clinic
KMID : 0980320160160030217
Abstract
Dental treatment is often performed under general anesthesia or sedation when an intellectually disabled patient has a heightened fear of treatment or has difficulty cooperating. When it is impossible to control the patient due to the severity of intellectual disability, conscious sedation is not a viable option, and only deep sedation should be performed. Deep sedation is usually achieved by propofol infusion using the target controlled infusion (TCI) system, with deep sedation being achieved at a slightly lower concentration of propofol in disabled patients. In such cases, anesthesia depth monitoring using EEG, as with a Bispectral Index (BIS) monitor, can enable dental treatment under appropriate sedation depth. In the present case, we performed deep sedation for dental treatment on a 27-year-old female patient with mental retardation and severe dental phobia. During sedation, we used BIS and a newly developed Anesthetic Depth Monitor for Sedation (ADMS™), in addition to electrocardiography, pulse oximetry, blood pressure monitoring, and capnometry for patient safety. Oxygen was administered via nasal prong to prevent hypoxemia during sedation. The BIS and ADMS™ values were maintained at approximately 70, and dental treatment was successfully performed in approximately 30 min.
키워드
ADMS; Anesthesia depth monitoring; Disabilities; Propofol; Sedation
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