An experience in General Anesthesia for Dental Treatment of an Obese Mentally Retarded Patient

Abstract

We administered general anesthesia for dental treatment of an obese patient with mental retardation. The obesity makes difficulties for respiratory management in the perioperative stage due to the raised diaphragm and fatty mediastinum. When the obese patient is mentally retarded, his manegement will be complicated ever further. Case:18 years of age male,165 cm and 115 Kg,The patient’s understanding and cooperation were so poor that the sedation technique did not take effect satisfactory. The administration of general anesthetic was planrled for his dental treatment. Anesthesia was induced with Ketalal and maintained with N₂O, O₂and sevoflurane. During the operation,the patient was kept on controlled ventilation monitoring by percutaneous SpO₂, arterial blood gas analysis, etc. without any complications. Transferred to the ward after emergence, he became delirious and manifested panic such as self-inluring and crying. We thought that the environmental changes caused these behaviors, and any respiratory trouble was not observed, then the patient was discharged、 For the obese patient with mental retardation, inability to adapt to a change of surroundings should be considered in addition to the perioperative management of respiration.