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진행성 치성 감염병소에서 부적절한 진정요법과 국소마취 시행하 절개 배농술에 따른 과환기증

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Author(s)
오지현손정석유재하김종배
Keimyung Author(s)
Kim, Jong Bae
Department
Dept. of Dentistry (치과학)
Journal Title
대한치과마취과학회지
Issued Date
2014
Volume
14
Issue
1
Keyword
HyperventilationIncision & drainageLocal amesthesiaOdontogenic infectionPsychosedation
Abstract
Extension of advanced odontogenic infection from deep neck fascial spaces into the mediastinum is heralded by chest pain,
dyspnea, fever, and radiographic demonstration of mediastinal widening. The critical care should be done in a team approach
by multiple medical and dental departments, such as, oral & maxillofacial surgery, otolaryngology, anesthesiology, chest surgery,
and infection medicine. Especially, fluid & drug therapy, adequate incision & drainage and systemic supportive psychosedation
care are important. But, acute hyperventilation can be produced by several distinct causes: severe anxiety, respiratory alkalosis,
increased blood catecholamine levels, and a decrease in the level of the ionized calcium in the blood. The orofacial fears
about acute pain, trismus, dysphagia, swelling and oral surgical treatment lead to the severe anxiety and increased blood
catecholamine level by stress. Therefore, the most dental patient should be cared gently as the stress reduction protocol.
In spite of the care, hyperventilation was occurred during psychosedation and local anesthesia for incision and drainage of
the masticatory fascial space abscess with deep neck infection & mediastinitis. We suggest that the dental patient with
advanced odontogenic infection must be attention for the manifestation of hyperventilation, especially in the medically compromised
conditions.
Alternative Title
Hyperventilation due to Incision & Drainage under Inadequate
Psychosedation & Local Anesthesia in Advanced Odontogenic
Infectious Lesion
Keimyung Author(s)(Kor)
김종배
Publisher
School of Medicine
Citation
오지현 et al. (2014). 진행성 치성 감염병소에서 부적절한 진정요법과
국소마취 시행하 절개 배농술에 따른 과환기증. 대한치과마취과학회지, 14(1), 63–71. doi: 10.17245/jkdsa.2014.14.1.63
Type
Article
ISSN
1598-4044
DOI
10.17245/jkdsa.2014.14.1.63
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/39712
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Dentistry (치과학)
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