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2 . Figure 2. Devices for oxygenation and ventilation. (Compilation from personal slides and slides modified from the American Heart Association.) Figure 2. Devices for oxygenation and ventilation. (Compilation from personal slides and slides modified from the American Heart Association.) RESPIRATORY COMPLICATIONS Management of Respiratory Depression In general, the use of sedation has a positive influence on patients undergoing dental

Complications attributed to moderate and deep levels of sedation are more often associated with respiratory compromise and have been reviewed in a previous continuing education article in this journal. 1 Sedation, and general anesthesia for that matter, have minimal influence on overall cardiovascular function in reasonably healthy patients. In fact, cardiovascular complications may be even more likely during dental procedures using local anesthesia alone than when sedation is provided. However, respiratory compromise, excessive drug dosages, or inadequate

trigger breathing as carbon dioxide levels in the blood rise slightly above the normal threshold. All sedatives, opioids, and potent inhalation general anesthesia agents have the potential to depress central hypercapnic and/or peripheral hypoxemic drives. While this risk is minimal with moderate sedation, some degree of depression is likely during deep sedation and general anesthesia. Regardless of the level of sedation intended, one must be thoroughly skilled in managing respiratory depression in the event it should occur. Like any complication, management of

presentation were albuterol, aspirin, atorvastatin, clopidogrel, diltiazem, glipizide, losartan, hydrochlorothiazide, metoprolol, omeprazole, sertraline, and tiotropium. The patient acknowledged significant postoperative nausea and vomiting following her total right hip arthroplasty completed approximately 6 months prior to presentation to the oral and maxillofacial surgeon. She denied any complications from prior anesthetics. Preoperative physical examination of this American Society of Anesthesiologists IV patient's airway was notable for an edentulous

achieve the desired degree of sedation, resulting in the patient still not being able to cooperate. Safety is another important consideration, because sedation is a continuum and a practitioner must be prepared to rescue a patient who falls into a level of sedation deeper than intended and experiences complications. Sedation is replacing more advanced procedures but may be decreasing in use overall. 3 ORAL SEDATIVE AGENTS IN PEDIATRIC DENTISTRY The ideal sedative agent or combination of agents reduces anxiety and mitigates uncooperative

avoided in patients susceptible to hyperkalemia, such as those with muscular dystrophy or other myopathies. A full intubating dose of succinylcholine (1–2 mg/kg) should be considered if direct laryngoscopy and/or tracheal intubation is anticipated. Cardiovascular complications are not particularly common, but the emergency kit for advanced providers should include medications for managing tachyarrhythmias and hypertension should they occur. Narrow complex tachycardias are atrial in origin and can be managed with a beta blocker. Esmolol is ideal for this purpose

patients can also exhibit myriad various clinical features, as listed in Table 1 . 1 – 5 Table 1. Clinical Features of Myotonic Dystrophy Patients with DM can experience a myriad of complications from local anesthesia, sedation, and general anesthesia. 2 – 4 Complications often do not correlate with the severity of disease. 2 – 4 Careful review of medical and dental histories along with preanesthetic evaluation may or may not prevent potential complications. This case report presents

, comprising 31% of all hospital day surgeries within this age group. 5 The gold standard for airway management is endotracheal intubation, 6 a vital component of GA since the late 1800s that provides a secure patent airway, eases ventilation, and protects against laryngospasm and aspiration. 7 However, intubation may be associated with complications including failure of placement, trauma to the oral or nasal anatomy, bronchospasm, obstruction, aspiration, epistaxis, postoperative sore throat, and damage to the laryngeal tissues. 8 , 9 Therefore, anesthesia

, abnormal respiratory control, autonomic dysfunction, various sensitivities to both sedative drugs and volatile anesthetics, airway difficulty, and gastroesophageal reflux. We herein report a case in which intubated general anesthesia was performed 3 times for a patient with RTT who had several risk factors for developing postoperative respiratory complications. These factors primarily included a history of being bedridden, severe scoliosis, and an inability to perform postural changes or sputum expectoration by herself. CASE REPORT The