Abstract
This time, we experienced a case of extraction of a patient with frequent attacks of angina pectoris and complications of right unilateral partial paralysis who had been subjected to artificial valve replacement surgery. The patient was 39 years old male who had been indicated valvular disease at 14 years of age and subjected to artificial valve replacement surgery. Thereafter, he had been suffering from attacks of angina pectoris sometimes accompanied with occurrences of cerebral thrombosis. This time, we were requested to perform extraction on this patient. Hematological findings at the first examination showed elongated hemorrhagic time of 6 minutes due to the treatment with ticlopidine hydrochloride. The medication was discontinued on the day before extraction. In ECG, a slight decrease in ST was observed. The patient was admitted to the hospital on the day before extraction. Nitrous oxide inhalation was used as the psychosedative therapy. By the inhalation of 7l of O2 and 3l of N2O, appropriate sedative condition was obtained. Then, a local anesthetic was used for anesthesia and extraction was started. Monitoring during extraction showed no marked changes in ECG, blood pressure, or pulse rate. However, nitroglycerine was administered intravenously as a prophylactic treatment. There was no marked change in the patient after going back to ward and he was relieved and left the hospital on the next day.
