title: Use of moderate sedation for a patient with Down syndrome, intellectual disability, and Eisenmenger syndrome: a case report.
abstract: For patients who have Eisenmenger syndrome (ES), perioperative risks are high even for noncardiac surgery, such as dental extractions. We report on the case history of a 38-year-old male patient with Down syndrome (DS), intellectual disability (ID), and ES. The patient was scheduled for extraction of the right maxillary second molar tooth. His physical health was poor. Following oxygenation, midazolam was administered intravenously very slowly until the optimum sedative level was obtained, with a total dosage of 3.5 mg. There were no marked changes in vital signs during the perioperative period, and the patient was discharged the same day. This case suggests that moderate or conscious sedation using midazolam for dental treatment of a patient with DS, ID, and ES was well tolerated. Several critical points are presented in this review.
authors.affiliation: Division of Dental Anesthesiology, Department of Comprehensive Dentistry, Kanagawa Dental College, Yokohama Dental and Medical Clinic and Clinical Training Center, Yokohama, Kanagawa, Japan. teruhito@kdcnet.ac.jp
authors.forename: Teruhito
authors.initials: T
authors.lastname: Kunimatsu
authors.forename: Setsue
authors.initials: S
authors.lastname: Greenan
authors.forename: Anzu
authors.initials: A
authors.lastname: Yamashita
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Masakazu
authors.initials: M
authors.lastname: Ikeda
mesh_terms: D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods*; D016292:Procedural Sedation / Q000379:methods; D003730:Dental Care for Persons with Disabilities; D004314:Down Syndrome / Q000150:complications; D004541:Eisenmenger Complex / Q000150:complications*; D006801:Humans; D006993:Hypnotics and Sedatives; D008607:Intellectual Disability / Q000150:complications; D008297:Male; D008874:Midazolam / Q000008:administration & dosage; D014081:Tooth Extraction
chemical_list: D006993:Hypnotics and Sedatives; D008874:Midazolam