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Successful intravenous sedation using propofol and remifentanil in a patient with a gag refl ex: a case report
https://doi.org/10.15090/0002000375
https://doi.org/10.15090/000200037589fb494f-e116-45e7-9898-51f21cf22d8d
| 名前 / ファイル | ライセンス | アクション |
|---|---|---|
gifushika513_119124_2025.pdf (751 KB)
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| Item type | 紀要論文 / Departmental Bulletin Paper(1) | |||||
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| 公開日 | 2025-03-31 | |||||
| タイトル | ||||||
| タイトル | Successful intravenous sedation using propofol and remifentanil in a patient with a gag refl ex: a case report | |||||
| 言語 | en | |||||
| 言語 | ||||||
| 言語 | eng | |||||
| キーワード | ||||||
| 言語 | en | |||||
| 主題Scheme | Other | |||||
| 主題 | Remifentanil | |||||
| キーワード | ||||||
| 言語 | en | |||||
| 主題Scheme | Other | |||||
| 主題 | Gag refl ex | |||||
| キーワード | ||||||
| 言語 | en | |||||
| 主題Scheme | Other | |||||
| 主題 | Intravenous sedation | |||||
| キーワード | ||||||
| 言語 | en | |||||
| 主題Scheme | Other | |||||
| 主題 | Dental treatment | |||||
| 資源タイプ | ||||||
| 資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||
| 資源タイプ | departmental bulletin paper | |||||
| アクセス権 | ||||||
| アクセス権 | open access | |||||
| アクセス権URI | http://purl.org/coar/access_right/c_abf2 | |||||
| 著者 |
後藤, 隆志
× 後藤, 隆志× 櫻井, 学 |
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| 書誌情報 |
ja : 岐阜歯科学会雑誌 en : The Journal of Gifu Dental Society 巻 51, 号 3, p. 119-124, ページ数 6, 発行日 2025-02 |
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| 出版者 | ||||||
| 言語 | ja | |||||
| 値 | 岐阜歯科学会 | |||||
| 抄録 | ||||||
| 内容記述タイプ | Other | |||||
| 内容記述 | Intravenous sedation is a common approach for patients with gag reflex during dental procedures.However, deep sedation can lead to airway obstruction and coughing, hindering treatment. This case report describes the successful use of low-dose remifentanil for intravenous sedation in a 14-year-old intellectually disabled boy（ height: 176 cm, weight: 65 kg） with dental caries, who was referred to our hospital for severe gag refl ex and dental phobia. Assessment revealed a gagging severity index of grade IV, and dental treatment was planned under intravenous sedation with preoperative fasting（ normal meals: up to 6 h before sedation,clear liquids: up to 2 h before sedation）. In Treatment 1, midazolam（ 4 mg） and propofol（ target controlled infusion［ TCI］: 2.0‒2.5 μg/mL, total dose: 600 mg） were used for sedation, with a treatment time and sedation time of 86 min and 105 min, respectively. In Treatment 2, remifentanil （0.05‒0.1 μg/kg/min, total dose: 0.3 mg） and propofol（ TCI: 1.8‒2.0 μg/mL, total dose: 447 mg） were used, with a treatment and sedation time of 65 mins and 100 mins, respectively. Frequent coughing and body movement were observed during Treatment 1, resulting in persistent treatment interruptions. Conversely, Treatment 2 provided excellent intraoperative conditions with minimal coughing and improved vital sign stability, although mild respiratory depression was observed. Furthermore, Treatment 1 required airway management via chin lift maneuver due to oxygen desaturations. Regarding recovery time, Treatment 2 exhibited shorter times compared to Treatment 1 due to using a lower propofol dose. Low-dose remifentanil may be useful for intravenous sedation in patients with gag refl ex. While this approach off ers promise, potential side eff ects, including respiratory depression and muscle rigidity (leadpipe henomenon), should be considered. Careful monitoring of vital signs and preparedness for possible complications (e.g., airway devices, pharmacological antagonists, neuromuscular blocking agents)are therefore necessary when considering intravenous sedation for dental procedures. |
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| 言語 | en | |||||
| ISSN | ||||||
| 収録物識別子タイプ | EISSN | |||||
| 収録物識別子 | 2433-0191 | |||||
| 書誌レコードID | ||||||
| 収録物識別子タイプ | NCID | |||||
| 収録物識別子 | AN00053070 | |||||
| 著者版フラグ | ||||||
| 出版タイプ | VoR | |||||
| 出版タイプResource | http://purl.org/coar/version/c_970fb48d4fbd8a85 | |||||
| 関連サイト | ||||||
| 関連タイプ | isVersionOf | |||||
| 識別子タイプ | NCID | |||||
| 関連識別子 | AN00053070 | |||||
| 見出し | ||||||
| 大見出し | Case Reports | |||||
| 言語 | en | |||||
