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  • CASE PRESENTATION
  • DISCUSSION
  • CONCLUSION
  • REFERENCES
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Premedication is often used to reduce the stress associated with anesthesia-related procedures. However, in some cases, patients may not cooperate with medication delivery because of significant fear and anxiety. We report a case of an uncooperative patient with severe intellectual disabilities who was successfully premedicated with the unique technique of sublingual midazolam administration using a suction toothbrush. The 38-year-old male patient was planned to receive dental treatment under deep intravenous sedation (IVS), but he refused both intravenous cannulation and mask induction. Preanesthetic medication delivery using other routes was attempted but not accepted. As the patient tolerated toothbrushing, we used repeated practice with sublingual water administration through the toothbrush's suction hole to gradually desensitize the patient. Using that same method, sublingual midazolam was administered as a successful premedication to allow placement of a face mask for inhalational induction without distress and completion of the dental treatment under IVS. For patients who refuse other premedication routes, sublingual administration during toothbrushing with a suction toothbrush may provide a successful alternative.

Keywords: Intellectual disability; Developmental disorder; Sublingual administration; Suction toothbrush
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Copyright: © 2023 by the American Dental Society of Anesthesiology
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Article Contents

Perioperative Management of a Patient With Idiopathic Pulmonary Hypertension and a History of Syncope: A Case Report

Aiji Sato (Boku) DDS, PhD;,
 MinHye So MD, PhD;,
 Kazuma Fujikake MD, PhD;,
 Motoshi Tanaka MD;,
 Yuji Kamimura MD, PhD;,
 Haruko Ota MD, PhD;,
 Tomomi Mizutani DDS,
 Kenichiro Ishibashi DDS, PhD;,
 Yasuyuki Shibuya DDS, PhD;, and
 Kazuya Sobue MD, PhD

How Safe Is Anesthesia Management by Dentist Anesthesiologists? The Need for an International Collaborative Study on the Safety of Anesthesia Management by Dentist Anesthesiologists

Takuro Sanuki DDS, PhD,
 Shota Tsukimoto DDS, PhD,
 Hidetaka Kuroda DDS, PhD,
 Uno Imaizumi DDS, PhD, and
 Naotaka Kishimoto DDS, PhD

General Anesthetic Management of a Patient With Spondyloepiphyseal Dysplasia Congenita Undergoing Palatoplasty Revision

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 Aiji Sato (Boku) DDS, PhD,
 Mayuko Kanazawa DDS, PhD,
 Erika Harada DDS,
 Mami Asai DDS,
 Yuko Shikama DDS,
 Hiroko Kobayashi DDS,
 Makoto Hirohata DDS,
 Naoko Tachi DDS, PhD, and
 Masahiro Okuda MD, PhD
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