• M Shahnaz Hasan and Lucy Chan.
• Senior Lecturer and Consultant Anesthesiologist, Department of Anesthesiology, University of Malaya Faculty of Medicine, Kuala Lumpur, Malaysia. Electronic address: shahnaz@ummc.edu.my.
• J. Oral Maxillofac. Surg. 2014 Oct 1; 72 (10): 1920.e1-4.

AbstractTreating children with cyanotic congenital heart disease poses many challenges to anesthesiologists because of the multiple problems associated with the condition. The anesthetic technique and drugs used perioperatively can affect a patient's physiologic status during surgery. The adherence to certain hemodynamic objectives and the avoidance of factors that could worsen the abnormal cardiopulmonary physiology cannot be overemphasized. In the present case series, we describe the use of a dexmedetomidine-ketamine combination for dental extraction in spontaneously breathing children with cyanotic congenital heart disease. The anesthetic concerns regarding airway management, the pharmacologic effects of drugs, and maintenance of adequate hemodynamic, blood gases, and acid-base status are discussed.Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

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