Abstract
Dissociative identity disorder (DID) is characterized by the existence of two or more separate and distinct personalities on an ongoing basis. Although the incidence of DID has been increasing in Japan, dental treatments for such patients remain rare. Here, we report our experience providing general anesthesia to a patient with DID and generalized anxiety disorder.
A 30s woman had been diagnosed as having DID at the age of 24 years, and her condition was being managed with medication. Although more than nine personalities had appeared as of the presently reported treatment, her original personality had not appeared for several years. She had numerous dental caries and an extreme fear of dental treatments. Therefore, we planned to perform dental treatments under general anesthesia.
Anesthesia was maintained with 3.0 μg/ml of propofol and 0.05-0.1 μg/kg/min of remifentanil hydrochloride. Since DID patients can respond to anesthetics differently than healthy adults, we used a BIS monitor to ascertain the depth of the anesthesia. Furthermore, the dentists, nurses, and other staff members shared information during the perioperative period. As a result, while changes in the patient’s personality were observed, no serious mental disturbances occurred.
