Experience of Dental Treatment Using Nitrous Oxide Inhalation Sedation Method for an Intubation Patient with Speech Cannula due to Trachea Osteomalacia

Abstract

Trachea osteomalacia is a condition in which the tracheal lumen is greatly collapsed during exhalation or intrathoracic pressure rise due to general or local fragility of the tracheal wall.

We performed dental treatment in an intubation patient with speech cannula for trachea osteomalacia. The patient had mental retardation and would not cooperate with maintaining the opening, so we used the nitrous oxide inhalation sedation method. Regarding respiratory management, special consideration for pneumonia prevention and trachea osteomalacia was necessary. Since the structure of the speech cannula is a non-rebreathing type circuit having a one-way valve and a side hole, care was taken to humidify the anesthetic gas and open air in the clinic supplied to the respirator. For trachea osteomalacia, caution was required to minimize mechanical compression stimulus from inside and outside the airway. In preparation for accidental symptoms, a circulatory anesthesia machine and a usual cuffed cannula were prepared for a suction catheter in the trachea and for positive pressure assisted respiration.

By minimizing the chair time, it was possible to avoid accidental symptoms.