Application of Monitored Anesthesia Care Using Dexmedetomidine to Common Oral and Maxillofacial Trauma Cases

다국어 초록 (Multilingual Abstract)

Oral and maxillofacial surgery (OMFS) trauma cases are commonly treated under general anesthesia. The purpose of this case report is to introduce an alternative method of anesthesia in patients who refuse general anesthesia. A combination of dexmedetomidine and ketamine for sedation anesthesia in 3 frequent fracture types in the field of OMFS—Le Fort I fracture, mandibular fracture, and alveolar bone fracture—was used. Dexmedetomidine as the single agent has not shown stable success rates for invasive procedures. To overcome some of the pitfalls with dexmedetomidine, combination sedation using ketamine was performed. Visual analogue scale scores were recorded postoperatively. Dexmedetomidine combined with ketamine administration provided safe and effective sedation and anxiolysis for surgical reduction and internal fixation of OMFS fractures. It showed advantages of decreased admission time, reduced expenses, minimal pain, and reduced anesthetic burden for the patient thus ultimately increasing overall satisfaction.

참고문헌 (Reference)

1 Penney R, "Use of dexmedetomidine and ketamine infusions during scoliosis repair surgery with somatosensory and motor-evoked potential monitoring: a case report" 78 : 446-450, 2010

2 Shukry M, "Update on dexmedetomidine:use in nonintubated patients requiring sedation for surgical procedures" 6 : 111-121, 2010

3 Arain SR, "The efficacy, side effects, and recovery characteristics of dexmedetomidine versus propofol when used for intraoperative sedation" 95 : 461-466, 2002

4 Hall JE, "Sedative, amnestic, and analgesic properties of small-dose dexmedetomidine infusions" 90 : 699-705, 2000

5 Munro HM, "Initial experience with dexmedetomidine for diagnostic and interventional cardiac catheterization in children" 17 : 109-112, 2007

6 Tobias JD, "Dexmedetomidine and ketamine: an effective alternative for procedural sedation?" 13 : 423-427, 2012

7 이수경, "Clinical use of dexmedetomidine in monitored anesthesia care" 대한마취통증의학회 61 (61): 451-452, 2011