Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：The Japanese Dental Society of Anesthesiology  

<p>  Multiple chemical sensitivity is a disease in which autonomic and neuropsychiatric symptoms, such as fatigue, headache, joint pain, insomnia, and dermatitis, occur in response to exposure to a trace amount of a chemical substance. Here, we report the management of intravenous sedation for tooth extraction and caries treatment in a patient with multiple chemical sensitivities.</p><p>  A 57-year-old woman visited a nearby dental clinic complaining of dentin hypersensitivity and requiring tooth extraction and treatment for a root fracture in the mandibular right second molar and caries in the mandibular right first premolar. However, she had a history of chemical hypersensitivity and dentophobia. She was referred to our hospital and was scheduled to undergo intravenous sedation in an environment with minimal exposure to inducers.</p><p>  We monitored her blood pressure, percutaneous arterial oxygen saturation (SpO₂), and pulse, and a single dose of midazolam (2 mg) and propofol (10 mg) was administered after securing an intravenous route. The continuous administration of propofol was started at 3 mg/kg/h under 3 L/min of oxygen after the patient fell asleep. No symptoms or risks associated with multiple chemical sensitivity were observed during the tooth extraction or caries treatment.</p><p>  The patient was successfully treated in an environment that eliminated the triggers for the onset of symptoms of multiple chemical sensitivity after meticulous interviews with specialists in collaboration with each clinical department. Intravenous sedation using midazolam and propofol under 3 L/min oxygen was a successful approach for minimizing the psychosomatic mechanisms of multiple chemical sensitivity in a patient with dentophobia.</p>

DOI： 10.24569/jjdsa.51.1_4

CiNii Research

Language：Japanese   Publisher：Japanese Society of Orofacial Pain  

<b>Patients</b>: After a 38-year-old female underwent extraction of tooth 38, which was in close proximity to the mandibular canal, she presented with mental nerve dysesthesia. She was then prescribed vitamin B12. However, her symptoms remained unchanged one month after starting the medication; thus, she requested treatment at a pain clinic. Under the diagnosis of trigeminal neuropathy, she was treated with a stellate ganglion block and acupuncture. After 20 sessions of stellate ganglion block treatment, the pain shifted from dysesthesia to paresthesia; however, there was no significant improvement in subjective symptoms, and the patient was unsure about continuing the treatment. Improvement was observed in the precise tactile function and the electric current perception threshold tests, and these positive results were conveyed to the patient. The patient wanted to continue treatment. After 10 sessions of acupuncture, she was again re-examined. Further improvement was observed in the precise tactile function and the electric current perception threshold tests, and these positive results were conveyed to the patient. As the patient was satisfied with the treatment results and the improvement in her symptoms, she requested treatment cessation.
<br><b>Discussion</b>: As in the present case, there are cases in which laboratory values improve despite no change in patient complaints about symptoms.
<br><b>Conclusions</b>: Therefore, for patients, particularly those with orofacial pain, who are hesitant to continue treatment due to a lack of observable change in symptoms, a qualitative examination and provision of feedback on test results showing improvement can be useful in enhancing their decision-making regarding the treatment, thus contributing to the overall improvement in patient satisfaction.

DOI： 10.11264/jjop.15.27

CiNii Research

Language：Japanese  

DOI： 10.1016/j.joms.2021.06.019

Scopus

PubMed

Event date： 2024.10

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Venue：オンライン開催   Country：Japan  

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Language：Japanese   Presentation type：Poster presentation  

Venue：オンライン開催   Country：Japan  

Event date： 2021.9

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：オンライン開催   Country：Japan