著者

井上 晶子 谷山 貴一 石田 麻依子 小川 さおり 湯川 譲治 澁谷 徹 INOUE AKIKO TANIYAMA KIICHI ISHIDA MAIKO OGAWA SAORI YUKAWA JOJI SHIBUTANI TOHRU

出版者

松本歯科大学学会

雑誌

松本歯学 = Journal of the Matsumoto Dental University Society (ISSN:21887233)

巻号頁・発行日

vol.43, no.1, pp.10-14, 2016-06-30

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The purpose of this study is to evaluate the rate of incidence and risk factor of postoperative nausea and vomiting (PONV) in patients who underwent orthognathic surgery. The subjects were 84 patients aged 1₅–₅2 years old (3₇ males and 4₇ females) who underwent orthognathic surgery under general anesthesia in Matsumoto Dental University Hospital from January 2011 to October 2016. The operation methods were sagittal split ramus osteotomy (SSRO) 44 cases, SSRO and Le Fort I osteotomy(Le Fort I)28 cases, SSRO, Le Fort I and genioplasty 6 cases, SSRO and genioplasty 4 cases, Le Fort I and anterior maxillary alveolar osteotomy 1 case, and SSRO, Le Fort I and genioplasty with upper and lower alveolar bone osteotomy 1case. Anesthesia was maintained with nitrous oxide or air in oxygen, sevoflurane or desflurane, remifentanil and fentanyl. The factors investigated were age, gender, minimum alveolar concentration hours (MAC hours), use of nitrous oxide, remifentanil dose, anesthesia time and the type of surgery. Statistical investigation was preformed using logistic regression analysis to confirm the significance between the incidence of PONV and follows; age, gender, MAC hours, use of nitrous oxide, remifentanil dose, anesthesia time and the type of surgery. The rate of incidence in nausea was ₇₇%, and that in vomiting was 3₅%. The incidence of nausea was 4.4 times higher in females than males. The incidence of vomiting was 4.6 times higher in cases with nitrous oxide than those without nitrous oxide.

著者

大野 忠男 谷山 貴一 隅田 佐知 芝 規良 澁谷 徹

出版者

松本歯科大学学会

雑誌

松本歯学 (ISSN:03851613)

巻号頁・発行日

vol.39, no.1, pp.12-15, 2013-06-30

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The allergic reactions to drugs are divided into two types ; type I (anaphylactic or fast type) and type IV (delayed type). The anaphylactic type is due to the specific IgE antibody and the reactions occur immediately after the administration of the causal drugs. On the other hand, the delayed type is due to the specific T cell and the reactions are more slowly. We experienced a case who suffered from delayed type allergic reaction twice after dental treatment. At the first time, the patient’s lower firstmolar was extracted under local anesthesia with 3% prilocaine with felypressin and he had acetaminophen for the postoperative pain. At second time, scaling was done under surface anesthesia with COPARON which contains 6% tetracaine hydrochloride. We performed the drug−induced lymphocyte stimulation test ; DLST and the challenge test. It was ascertained from the anamnesis and the results of allergic tests that the causal drugs for the allergic reactions were 3% prilocaine with felypressin and COPARON . 2%lidocaine for surface anesthesia, 2% lidocaine with adrenaline, acetaminophen and cefdinir were safely used.