Abstract
It should be advised to employ a suitable respiratory monitor during dental treatment of patients with disease affecting the respiratory function. In the present study, the end tidal carbon dioxide (ETCO2), arterial oxygen saturation (SpO2)and respiratory rate (RR) were measured simultaniously from both healthy and medically compromised patients using the 4700 Oxicap® monitor (Ohmeda) and the usefulness of capnometer for the respiratory monitoring during dental treatment was evaluated.
When the respiratory volume (RV) of healthy adults (n=10) was voluntarily reduced, all of them showed a decrease in SpO2 and an increase in ETCO2 without change in RR, indicating a close relationship between RV and SpO2 and ETCO2. Although the fluctuation of ETCO2 became slightly larger than the pretreatment level, neither ETCO2 nor SpO2 showed significant change throughout the dental treatment in healthy children (n=10). On the other hand, SpO2 decreased during local anesthesia and dental treatment in patients with cerebral palsy (CP), suggesting poor ability to recover from hypoventilation which is supposed to be caused by stress. We did not observe an apparent increase in ETCO2 during dental treatment in CP patients. Apnea, which occured spontaneously during dental treatment of patients with CP or Rett syndrome, was detected promptly by the capnometer module in 4700 Oxicap as a disappearance of exhalation in the CO2waveform. The change in the CO2 waveform was followed by changes of ETCO2and SpO2 values which lagged by 20-40 sec.
In the patients with disease affecting the respiratory function, the capnometer appears to be a useful respiratory monitor during dental treatment and the combination of capnometer and pulse oximeter seems to be the most powerful system for respiratory monitoring.
