J Korean Dent Soc Anesthesiol.  2011 Dec;11(2):146-152. 10.17245/jkdsa.2011.11.2.146.

Dental Treatment of a Patient with Alzheimer Disease under Ambulatory General Anesthesia

• Kim MS
• Seo KS
• Kim HJ
• Han HJ
• Shin TJ
• Chang J

• KMID: 2425212
• DOI: http://doi.org/10.17245/jkdsa.2011.11.2.146

Abstract

BACKGROUND
Elderly patients with progressive dementia including Alzheimer's disease (AD) are more and more often scheduled to undergo general anesthesia for various pathologies including dental problem. But, there is high risk of deterioration of underlying mental diseases and other co-morbidities. So it is important to implement preventive strategies and take adequate measures to minimize negative perioperative events in these patients.
METHODS
We reviewed the 17 cases of 11 patients with AD who underwent ambulatory general anesthesia for dental treatment at the clinic for the disabled in Seoul National University Dental Hospital.
RESULTS
The mean age was 68 (57-81) years. All of them were diagnosed with AD and some had hypertsnsion, bronchiectasis, urinary incontinence. For anesthesia induction, 3 cases (1 patient) was needed physical restraint, but others showed good or moderate cooperation. Drugs used for anesthesia induction was thiopental (11 cases), propofol (3 cases) and sevoflurane (3 cases). All patients received nasotracheal intubation without difficulties. Mean total anesthetic time was 3 hour 44 min ± 60 min and staying time at PACU was 83 ± 34 min. All the patients except one who showed hypertension discharged without any complication. There was no death or long term hospitalization because of severe complications.
CONCLUSIONS
If general anesthesia is needed, pertinent diagnostic tests and workup about other medical problems, and appropriate anesthetic planning are essential for safety.

Keyword

Alzheimer; General anesthesia; Dental treatment; Disabilities

MeSH Terms

Aged
Alzheimer Disease*
Anesthesia
Anesthesia, General*
Bronchiectasis
Dementia
Diagnostic Tests, Routine
Hospitalization
Humans
Hypertension
Intubation
Pathology
Propofol
Restraint, Physical
Seoul
Thiopental
Urinary Incontinence
Propofol
Thiopental