Multiple dental extractions using general anesthesia for a patient with Down and Eisenmenger syndromes and periodontal disease.
A patient with Down syndrome and severe retardation and Eisenmenger syndrome sought dental treatment at the Oregon Health Sciences University Hospital Dental Service. Eisenmenger syndrome is a form of cyanotic congenital cardiovascular pulmonary disease. The cardiac structural abnormalities associated with Eisenmenger syndrome preclude the use of conscious sedation and predispose a patient to the development of bacterial endocarditis. A prophylactic antibiotic regimen is recommended for patients with Eisenmenger syndrome who are undergoing procedures that produce a transient bacteremia. This article reviews the appropriate measures necessary for the safe anesthetic, operative, and perioperative care of a severely compromised patient. It is based on an understanding of the pathophysiology associated with Eisenmenger syndrome.
Bozich
J G
JG
Hospital Dental Service, Oregon Health Sciences University, Portland 97201-3098, USA.
Albert
T W
TW
D000328:Adult; D000766:Anesthesia, Dental; D000768:Anesthesia, General; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D004314:Down Syndrome / Q000150:complications*; D004541:Eisenmenger Complex / Q000150:complications*; D004697:Endocarditis, Bacterial / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010510:Periodontal Diseases / Q000150:complications* / Q000628:therapy; D014081:Tooth Extraction; D014640:Vancomycin / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D014640:Vancomycin