title: Oral surgery under local anesthesia with dexmedetomidine sedation in a morbidly obese patient with aortic dissection.
abstract: We report a case of a morbidly obese man with an aortic aneurysm, in whom dental surgery was performed before elective cardiac surgery. His aortic aneurysm required emergency surgery. However, because of his morbid obesity, elective cardiac surgery was planned. Considering the high risk of infective endocarditis, dental surgery was required. Our patient was at a high risk of aortic rupture caused by hypertension and breathing difficulty in the supine position. Dexmedetomidine (DEX) is an anti-anxiety, sedative, and analgesic medicine that can stabilize circulatory dynamics and minimize blood pressure fluctuations. We administered intravenous DEX for sedation of the patient in Fowler's position. In conclusion, our understanding of the risk factors of DEX enabled us to perform safe invasive oral treatment.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
authors.forename: Mika
authors.identifier: 0000-0002-7548-7613
authors.initials: M
authors.lastname: Seto
authors.affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
authors.forename: Michitaka
authors.identifier: 0000-0003-1149-7924
authors.initials: M
authors.lastname: Matsuda
authors.affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
authors.forename: Kyoichi
authors.identifier: 0000-0002-9485-2102
authors.initials: K
authors.lastname: Narihira
authors.affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
authors.forename: Toshihiro
authors.identifier: 0000-0002-8676-5965
authors.initials: T
authors.lastname: Kikuta
keywords: Aortic aneurysm; Local anesthetics; Morbid obesity; Oral surgical procedures