@article{oai:mdu.repo.nii.ac.jp:00000456,
 author = {澁谷, 徹},
 issue = {1},
 journal = {松本歯学},
 month = {Apr},
 note = {application/pdf, Various systemic complications may occur in dental practice due to psychological and physiological stress. The most frequent is neurogenic shock or syncope, and the second is hyperventilation syndrome. These complications are generally classified as mild and do not threaten the life of patients. However, severe complications such as anaphylactic shock, myocardial infarction and cerebrovascular disorders rarely occur during dental treatment and may result in death. Therefore, dentists should be fully aware of the systemic complications that may occur in dental practice and make efforts to avoid these complications. This paper reviews the pathophysiology and preventive measures of relatively frequent complications: neurogenic shock, hyperventilation syndrome, allergic reaction to drugs, cardiovascular diseases. It is important to appropriately evaluate the cardiopulmonary reserve of patients with cardiovascular diseases for their safe management. Inhalation sedation with nitrous oxide and intravenous sedation with benzodiazepines or propofol are very useful to reduce psychological stress following dental treatment. As painful stimuli lead to elevation of blood pressure and heart rate, dental treatment should be painless using local anesthesia. Vasoconstrictors such as epinephrine are contained in the local anesthetics used in dentistry to increase the effect and length of local anesthesia, but they may increase cardiac output and cardiac oxygen consumption. Therefore we should choose an appropriate local anesthetic considering the reliable anesthetic effects and few hemodynamic side effects. Various monitors, such as blood pressure, pulse rate, pulse oxymetory and electrocardiogram, are necessary to know the hemodynamic changes during dental treatment. It is possible to prevent severe complications by identifying dangerous hemodynamic changes in the early stages and coping with them appropriately.},
 pages = {1--9},
 title = {歯科治療時に生じる全身偶発症の防止対策},
 volume = {33},
 year = {2007}
}