Limits...
Management of post-hyperventilation apnea during dental treatment under monitored anesthesia care with propofol.

Kobayashi M, Kurata S, Sanuki T, Okayasu I, Ayuse T - Biopsychosoc Med (2014)

Bottom Line: A 17-year-old female who suffered from hyperventilation syndrome for several years developed post-hyperventilation apnea after treatment using the paper bag rebreathing method and sedative administration during a dental procedure.We subsequently successfully provided her with monitored anesthesia care with propofol.This case demonstrates that appropriate emergency treatment should be available for patients with hyperventilation attacks who are at risk of developing post-hyperventilation apnea associated with hypoxemia and loss of consciousness.

View Article: PubMed Central - PubMed

Affiliation: Department of Dental Anesthesiology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki-shi, 852-8588 Japan.

ABSTRACT
Although hyperventilation syndrome generally carries a good prognosis, it is associated with the risk of developing severe symptoms, such as post-hyperventilation apnea with hypoxemia and loss of consciousness. We experienced a patient who suffered from post-hyperventilation apnea. A 17-year-old female who suffered from hyperventilation syndrome for several years developed post-hyperventilation apnea after treatment using the paper bag rebreathing method and sedative administration during a dental procedure. We subsequently successfully provided her with monitored anesthesia care with propofol. Monitored anesthesia care with propofol may be effective for the general management of patients who have severe hyperventilation attacks and post-hyperventilation apnea. This case demonstrates that appropriate emergency treatment should be available for patients with hyperventilation attacks who are at risk of developing post-hyperventilation apnea associated with hypoxemia and loss of consciousness.

No MeSH data available.


Related in: MedlinePlus

Time course of the third episode. Propofol was used for general management.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4260203&req=5

Fig3: Time course of the third episode. Propofol was used for general management.

Mentions: Several weeks later, the same patient was scheduled for dental treatment under monitored anesthesia care with spontaneous breathing plus regional anesthesia. We induced and maintained anesthesia for one hour with a target controlled infusion of propofol (TCI level = 1.1 ~ 1.2 μg/ml) after intravenous administration of 1 mg midazolam. At the end of treatment, propofol was discontinued and the patient was carefully observed by the anesthesiologist until return of consciousness. Although she regained consciousness 20 minutes after stopping the propofol infusion, hyperventilation with a respiratory rate of 40 breaths/minute occurred and continued for several minutes. Immediately after the hyperventilation subsided spontaneously, post-hyperventilation apnea with desaturation to 86% occurred in association with loss of consciousness. However, the patient regained consciousness within one minute without any therapeutic intervention. She was discharged after confirming full recovery from the unstable respiratory condition.


Management of post-hyperventilation apnea during dental treatment under monitored anesthesia care with propofol.

Kobayashi M, Kurata S, Sanuki T, Okayasu I, Ayuse T - Biopsychosoc Med (2014)

Time course of the third episode. Propofol was used for general management.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4260203&req=5

Fig3: Time course of the third episode. Propofol was used for general management.
Mentions: Several weeks later, the same patient was scheduled for dental treatment under monitored anesthesia care with spontaneous breathing plus regional anesthesia. We induced and maintained anesthesia for one hour with a target controlled infusion of propofol (TCI level = 1.1 ~ 1.2 μg/ml) after intravenous administration of 1 mg midazolam. At the end of treatment, propofol was discontinued and the patient was carefully observed by the anesthesiologist until return of consciousness. Although she regained consciousness 20 minutes after stopping the propofol infusion, hyperventilation with a respiratory rate of 40 breaths/minute occurred and continued for several minutes. Immediately after the hyperventilation subsided spontaneously, post-hyperventilation apnea with desaturation to 86% occurred in association with loss of consciousness. However, the patient regained consciousness within one minute without any therapeutic intervention. She was discharged after confirming full recovery from the unstable respiratory condition.

Bottom Line: A 17-year-old female who suffered from hyperventilation syndrome for several years developed post-hyperventilation apnea after treatment using the paper bag rebreathing method and sedative administration during a dental procedure.We subsequently successfully provided her with monitored anesthesia care with propofol.This case demonstrates that appropriate emergency treatment should be available for patients with hyperventilation attacks who are at risk of developing post-hyperventilation apnea associated with hypoxemia and loss of consciousness.

View Article: PubMed Central - PubMed

Affiliation: Department of Dental Anesthesiology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki-shi, 852-8588 Japan.

ABSTRACT
Although hyperventilation syndrome generally carries a good prognosis, it is associated with the risk of developing severe symptoms, such as post-hyperventilation apnea with hypoxemia and loss of consciousness. We experienced a patient who suffered from post-hyperventilation apnea. A 17-year-old female who suffered from hyperventilation syndrome for several years developed post-hyperventilation apnea after treatment using the paper bag rebreathing method and sedative administration during a dental procedure. We subsequently successfully provided her with monitored anesthesia care with propofol. Monitored anesthesia care with propofol may be effective for the general management of patients who have severe hyperventilation attacks and post-hyperventilation apnea. This case demonstrates that appropriate emergency treatment should be available for patients with hyperventilation attacks who are at risk of developing post-hyperventilation apnea associated with hypoxemia and loss of consciousness.

No MeSH data available.


Related in: MedlinePlus