Multiple chemical sensitivity is a disease in which autonomic and neuropsychiatric symptoms, such as fatigue, headache, joint pain, insomnia, and dermatitis, occur in response to exposure to a trace amount of a chemical substance. Here, we report the management of intravenous sedation for tooth extraction and caries treatment in a patient with multiple chemical sensitivities.

  A 57-year-old woman visited a nearby dental clinic complaining of dentin hypersensitivity and requiring tooth extraction and treatment for a root fracture in the mandibular right second molar and caries in the mandibular right first premolar. However, she had a history of chemical hypersensitivity and dentophobia. She was referred to our hospital and was scheduled to undergo intravenous sedation in an environment with minimal exposure to inducers.

  We monitored her blood pressure, percutaneous arterial oxygen saturation (SpO₂), and pulse, and a single dose of midazolam (2 mg) and propofol (10 mg) was administered after securing an intravenous route. The continuous administration of propofol was started at 3 mg/kg/h under 3 L/min of oxygen after the patient fell asleep. No symptoms or risks associated with multiple chemical sensitivity were observed during the tooth extraction or caries treatment.

  The patient was successfully treated in an environment that eliminated the triggers for the onset of symptoms of multiple chemical sensitivity after meticulous interviews with specialists in collaboration with each clinical department. Intravenous sedation using midazolam and propofol under 3 L/min oxygen was a successful approach for minimizing the psychosomatic mechanisms of multiple chemical sensitivity in a patient with dentophobia.

Multiple Chemical Sensitivity (MCS) is a controversial disorder characterized by a recurrent set of diverse clinical manifestations, involving a broad spectrum of organ systems, that are induced by environmental chemicals at doses far below those usually harmful to most persons. To prevent MCS and other adverse effects on human health from environmental chemicals, concentration thresholds of frequently used chemicals in homes, workplaces, and schools are defined by several legal and administrative regulations. However, only a small percentage of the tens of thousands of environmental chemicals in use have been evaluated for toxicity and accumulation, and recent amendments of laws and regulations are directed toward comprehensive management of chemicals as a whole.

目的：電磁波過敏症合併

本研究は，

Due to chemical exposure, multiple chemical sensitivity (MCS) has become a severe problem. The mechanism of MCS, however, still needs to be clarified. This paper considers the role of science and policies regarding MCS. The Japanese government has taken measures to prevent and deal with MCS, such as setting guidelines for indoor chemical concentrations and registering the disease name for health insurance claims. However, since MCS patients have differing symptoms, a uniform policy is difficult to implement, so we must act with sympathy and empathy. MCS is no longer a rare disease; like hay fever, it can affect anyone. In the future, it is necessary to prevent patients from becoming severely ill and to prevent the occurrence of new MCS patients.