선천성 심장질환을 가진 다운증후군환자에서 치과치료를 위한 전신마취 시 산소포화도 하강 -증례보고-
DECREASE OF OXYGEN SATURATION DURING DENTAL TREATMENT UNDER GENERAL ANESTHESIA OF DOWN SYNDROME PATIENT WITH CONGENITAL HEART DISEASE -A CASE REPORT-
서광석, 장주혜, 신터전, 김현정,
소속 상세정보
서광석 ( Seo Kwang-Suk ) - 서울대학교 치과병원 치과마취과
장주혜 ( Chang Ju-Hea ) - 서울대학교 치과병원 장애인구강진료실
신터전 ( Shin Teo-Jeon ) - 서울대학교 치과병원 치과마취과
김현정 ( Kim Hyun-Jeong ) - 서울대학교 치과병원 치과마취과
KMID : 1144020090050010018
Abstract
A 26-year-old female patient with Down syndrome visited to recieve dental treatment under gnenral anesthesia 6 years ago. The patient had difficulties in oral examination, radiograph taking and laboratory test. The patient had congenital heart disease and medical consultation based on the echocardiography was provided by a cardiologist indicating that the patient could tolearte general anesthesia during dental treatment. And two times of general anesthesia were administered during a dental treament with the interval of 3 years and no postoperpative complicaton was reported. At the third dental operation, the patient had a relatively good condition and her prescreening test revealed no abnormalities. Without further consultation with a cardiologist, general anesthesia was administered to the patient. Anaesthesia was based on thiopental and ventilation of desflurane and in oxygen via an endotracheal tube with an appropriate monitoring. During the maintenance of anesthesia, the blood pressure of the patient started to drop and the oxygen saturation also began to decrease. Consequently, the proceding operation was discontinued and also inhalation anesthesia was ceased. As the patient was recovered from anesthesia, her systemic conditions were alleviated. After the complete recovery of the patient, she visited the cardiologist, and the cardiologic test revealed her severe right ventricular dilatation. In the anesthesia of patients with congenital heart disease, information on their systemic conditions needs to be undated from the medical consultation, which assures the safety of treatment.
키워드
Down syndrome; Congenital heart problem; Dental treatment; General anesthesia; mental retardation
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