Abstract
Intravenous sedation is commonly used to manage patients who experience fear, anxiety, or nervousness about dental procedures, ensuring a more comfortable and safer treatment experience. In this case, the patient had a history of refractory vasospastic angina and had previously experienced cardiovascular complications triggered by the stress of dental treatment. Consequently, the patient developed severe dental phobia and specifically requested dental care under intravenous sedation. Given the high risk of cardiovascular complications, meticulous sedation management was essential to minimize intraoperative mental and physical stress. The patient also had a history of undergoing central venous catheterization under intravenous sedation, during which sedation management was challenging. The patient transitioned unpredictably from moderate sedation to deep sedation levels comparable with general anesthesia. This history underscored the need for more precise sedation control in subsequent procedures. In cases where sedation depth is difficult to regulate, electroencephalogram （EEG） monitoring can provide objective confirmation of anesthetic depth, facilitating the achievement of an appropriate sedation level. During the dental procedure, the patient’s processed electroencephalographic index ranged between 60 and 80, while the Ramsay Sedation Scale score was maintained at 3. This case report highlights the utility of EEG monitoring in the sedation management of a patient with severe dental phobia and refractory coronary spasm angina pectoris.
