title: Dexmedetomidine and ketamine sedation for dental extraction in children with cyanotic heart disease.
abstract: Treating children with cyanotic congenital heart disease poses many challenges to anesthesiologists because of the multiple problems associated with the condition. The anesthetic technique and drugs used perioperatively can affect a patient's physiologic status during surgery. The adherence to certain hemodynamic objectives and the avoidance of factors that could worsen the abnormal cardiopulmonary physiology cannot be overemphasized. In the present case series, we describe the use of a dexmedetomidine-ketamine combination for dental extraction in spontaneously breathing children with cyanotic congenital heart disease. The anesthetic concerns regarding airway management, the pharmacologic effects of drugs, and maintenance of adequate hemodynamic, blood gases, and acid-base status are discussed.
authors.affiliation: Senior Lecturer and Consultant Anesthesiologist, Department of Anesthesiology, University of Malaya Faculty of Medicine, Kuala Lumpur, Malaysia. Electronic address: shahnaz@ummc.edu.my.
authors.forename: M Shahnaz
authors.initials: MS
authors.lastname: Hasan
authors.affiliation: Professor and Consultant Anesthesiologist, Department of Anesthesiology, University of Malaya Faculty of Medicine, Kuala Lumpur, Malaysia.
authors.forename: Lucy
authors.initials: L
authors.lastname: Chan
mesh_terms: D000136:Acid-Base Equilibrium / Q000187:drug effects; D058109:Airway Management / Q000379:methods; D000766:Anesthesia, Dental / Q000379:methods*; D001794:Blood Pressure / Q000187:drug effects; D002675:Child, Preschool; D016292:Procedural Sedation / Q000379:methods*; D017742:Dental Care for Chronically Ill; D020927:Dexmedetomidine / Q000008:administration & dosage*; D004314:Down Syndrome / Q000150:complications; D018691:Excitatory Amino Acid Antagonists / Q000008:administration & dosage*; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007649:Ketamine / Q000008:administration & dosage*; D008297:Male; D010100:Oxygen / Q000097:blood; D013771:Tetralogy of Fallot / Q000150:complications; D014081:Tooth Extraction / Q000379:methods*; D014188:Transposition of Great Vessels / Q000150:complications
chemical_list: D018691:Excitatory Amino Acid Antagonists; D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine; D007649:Ketamine; D010100:Oxygen