Pulmonary hypertension is characterized by higher-than-normal pulmonary arterial pressures. This case report describes the perioperative management of a male patient with idiopathic pulmonary hypertension and a history of vasovagal syncope during previous dental extractions with local anesthesia. He underwent successful extraction of a single tooth with intravenous moderate sedation using dexmedetomidine and midazolam as well as prilocaine with felypressin for local anesthesia. There are many considerations surrounding the anesthetic management of patients with pulmonary hypertension, including the need to maintain systemic blood pressure, avoid hypoxemia and hypercapnia, and ensure adequate analgesia.
Preoperative AP Chest Radiograph
The primary trunk of the pulmonary artery is dilated. (1) Inferior branch of the right pulmonary artery. (2) Left main pulmonary artery.
Preoperative 12-Lead Electrocardiogram
Electrocardiogram showed nonspecific T-wave abnormalities and a right axis deviation.
Contributor Notes
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ISSN: 0003-3006