Positioning of a Patient with Myelomeningocele during Intravenous Sedation for Dental Surgery：A Case Report

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  • 脊髄髄膜瘤を有する二分脊椎症患者の静脈内鎮静法下歯科治療時に体位への配慮を行った1症例

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Abstract

<p>Spina bifida is an aplasia of the spinal column, and three types are recognized：spina bifida occulta, meningocele, and myelomeningocele. Myelomeningocele is characterized by a sac filled with nerve tissue and meninges. Because of the protrusion of this sac, people with myelomeningocele spend their daily life in a sitting or prone position. Intravenous sedation is indicated for patients with dental phobia, and requires patients to stay in the supine position. Care in positioning a patient with myelomeningocele during intravenous sedation is very important to avoid sac injury. Therefore, during operation, the use of soft rolls and a donut-shaped cushion is recommended in order to disperse body pressure. We report a case of intravenous sedation in a 33-year-old man with myelomeningocele who required perioperative positioning. Sedation was induced with midazolam and propofol, and the sedation time was 65 minutes. During dental surgery, soft rolls and donut-shaped cushions were used, and treatment was completed in a short time. There were no injuries to the myelomeningocele during or after surgery.</p>

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