Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Dexmedetomidine sedation for a dental extraction in a patient with known difficult airway

Dexmedetomidine sedation for a dental extraction in a patient with known difficult airway Fibrodysplasia ossificans progressiva is an autosomal dominant condition that causes cervical spine fusion and ankylosis of the temporomandibular joint, resulting in anaesthetic challenges. Awake tracheal intubation with flexible bronchoscopy is recommended for general anaesthetics required by patients with this disease. This case report describes the novel approach of using dexmedetomidine sedation in combination with local anaesthesia to allow dental extraction of the fifth and seventh upper left teeth in a patient with fibrodyplasia ossificans progressive, who had a known difficult airway and profound thrombocytopenia. This procedure was not previously tolerated by the patient under local anaesthesia alone. The use of dexmedetomidine was successful in facilitating completion of the procedure with a high degree of patient satisfaction. We discuss the advantages of dexmedetomidine over other sedative agents due to its minimal effects on respiratory drive and airway muscle tone. We highlight the use of dexmedetomidine for complex cases such as this, where tracheal intubation is potentially challenging, but the procedure itself could be managed under sedation and local anaesthesia. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Anaesthesia Reports Wiley

Dexmedetomidine sedation for a dental extraction in a patient with known difficult airway

Guinness, F.; Coleman, M.; Gillbride, M.
Anaesthesia Reports , Volume 10 (2) – Jul 1, 2022
Download PDF
4 pages

Loading next page...
 
/lp/wiley/dexmedetomidine-sedation-for-a-dental-extraction-in-a-patient-with-NGc8ZOUAO0
Publisher
Wiley
Copyright
2022 © Association of Anaesthetists
eISSN
2637-3726
DOI
10.1002/anr3.12184
Publisher site
See Article on Publisher Site

Abstract

Fibrodysplasia ossificans progressiva is an autosomal dominant condition that causes cervical spine fusion and ankylosis of the temporomandibular joint, resulting in anaesthetic challenges. Awake tracheal intubation with flexible bronchoscopy is recommended for general anaesthetics required by patients with this disease. This case report describes the novel approach of using dexmedetomidine sedation in combination with local anaesthesia to allow dental extraction of the fifth and seventh upper left teeth in a patient with fibrodyplasia ossificans progressive, who had a known difficult airway and profound thrombocytopenia. This procedure was not previously tolerated by the patient under local anaesthesia alone. The use of dexmedetomidine was successful in facilitating completion of the procedure with a high degree of patient satisfaction. We discuss the advantages of dexmedetomidine over other sedative agents due to its minimal effects on respiratory drive and airway muscle tone. We highlight the use of dexmedetomidine for complex cases such as this, where tracheal intubation is potentially challenging, but the procedure itself could be managed under sedation and local anaesthesia.

Journal

Anaesthesia Reports – Wiley

Published: Jul 1, 2022

Keywords: airway assessment: co‐existing disease; dental extraction; dexmedetomidine; sedation

References

  • The natural history of heterotopic ossification in patients who have fibrodysplasia ossificans progressiva. A study of forty‐four patients
    Cohen, RB; Hahn, GV; Tabas, JA
  • General anaesthesia for dental procedures in patients with fibrodysplasia ossificans progressiva: a review of 42 cases in 30 patients
    Kilmartin, E; Grunwald, Z; Kaplan, FS; Nussbaum, BL
  • Deterioration of pulmonary function: an early complication in fibrodysplasia ossificans progressiva
    Botman, E; Smilde, BJ; Hoebink, M
  • Early mortality and cardiorespiratory failure in patients with fibrodysplasia ossificans progressiva
    Kaplan, FS; Zasloff, MA; Kitterman, JA; Shore, EM; Hong, CC; Rocke, DM
  • The medical management of fibrodysplasia ossificans progressiva: current treatment considerations
    Kaplan, FS; Mukaddam, MA; Baujat, G
  • Awake intubation
    Leslie, D; Stacey, M
  • Dexmedetomidine: its use in intensive care medicine and anaesthesia
    Scott‐Warren, VL; Sebastian, J
  • Dexmedetomidine for the management of awake fibreoptic intubation
    He, XY; Cao, JP; He, Q
  • Dexmedetomidine in the management of awake fiberoptic intubation
    Alfieri, A; Passavanti, MB; Di Franco, S
  • Dental extraction in the thrombocytopenic patient is safe and complications are easily managed
    Fillmore, JW; Leavitt, BD; Arce, K