J Dent Anesth Pain Med.  2017 Mar;17(1):65-69. 10.17245/jdapm.2017.17.1.65.

Dental treatment in patients with severe gag reflex using propofol-remifentanil intravenous sedation

• Shin S
• Kim S

• KMID: 2374726
• DOI: http://doi.org/10.17245/jdapm.2017.17.1.65

Abstract

Patients with severe gag reflex (SGR) have difficulty getting the treatment they require in local clinics, and many tend to postpone the start of their treatment. To address this problem, dentists have used behavioral techniques and/or pharmacological techniques for treatment. Among the pharmacological methods available, propofol IV sedation is preferred over general anesthesia because it is a simpler procedure. Propofol in combination with remifentanil is characterized by stable sedative effects and quick recovery, leading to a deep sedation. Remifentanil acts to reduce the pain caused by lipid-soluble propofol on injection. The synergistic effects of propofol-remifentanil include reduction in the total amount of drug required to achieve a desired sedation level and anti-emetic effects. In this case report, we outline how the use of propofol-remifentanil IV sedation enabled us to successfully complete a wide range of dental treatments in a patient with SGR.

Keyword

Dental Care; Gagging; Propofol; Remifentanil; Sedation

MeSH Terms

Anesthesia, General
Antiemetics
Deep Sedation
Dental Care
Dentists
Gagging
Humans
Hypnotics and Sedatives
Propofol
Reflex*
Antiemetics
Hypnotics and Sedatives
Propofol

Figure

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  Fig. 1 The treatment is initiated after the administration of oxygen using a nasal cannula.

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  Fig. 2 The target controlled infusion pumps are used to administer propofol and remifentanil.

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