J Korean Dent Sci.  2017 Dec;10(2):82-86. 10.5856/JKDS.2017.10.2.82.

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

Affiliations
  • 1Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gangdong, Korea.
  • 2CLINE Dental Clinic, Seoul, Korea.
  • 3Department of Dentistry (Oral and Maxillofacial Surgery), Catholic Kwandong University International St. Mary's Hospital, Incheon, Korea. cathead81@hotmail.com

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.

Keyword

Anesthesia; Dexmedetomidine; Fracture reduction; Ketamine; Maxillofacial surgery
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