上顎埋伏歯抜去の周術期管理に留意したポルフィリン症患者の1例 A patient with porphyria requiring special perioperative care for extraction of an upper impacted tooth
Acute intermittent porphyria (AIP) is a hereditary metabolic disease with a mortality rate of still 25% when clinical symptoms develop.<BR>We described our experience with extraction of an upper impacted wisdom tooth in a patient with AIP.<BR>The patient was a 35-year-old woman in whom AIP developed after celiotomy. Her condition deteriorated, and she became bedridden and was receiving rehabilitation. She had trismus due to pericoronitis of an upper wisdom tooth. We used safe antibiotics and performed an operation. To avoid stress, the patient was sedated with morphine and nitrous oxide and was sufficiently desensitized to pain with propitocaine. The prognosis was good.<BR>Clinical symptoms of AIP are often caused by agents such as carbamazepine, sulfa drugs, and lidocaine, which are used in clinical oral surgery. When surgery for treatment is done in patients with AIP, it is necessary to avoid stress, use safe drugs, sufficiently desensitize the patient to pain, and cooperate closely with other medical departments.
日本口腔外科学会雑誌 52(12), 743-747, 2006-12-20
Japanese Society of Oral and Maxillofacial Surgeons