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This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Copyright (c) 2025 Nur Izzati Ab Halim, Zubaidah Zulkipeli
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Abstract
We describe 2 successful cases of children with single ventricle physiology (SVP) who underwent dental rehabilitation under general anaesthesia, a scenario that carries significant challenges. Both patients received intranasal dexmedetomidine as premedication, which provided effective anxiolysis, facilitated intravenous access, and contributed to perioperative haemodynamic stability. One patient was maintained on sevoflurane, while the other received total intravenous anaesthesia with propofol and remifentanil. In both cases, deep extubation was performed safely, aided by dexmedetomidine’s sedative and sympatholytic properties and careful titration of anaesthetic depth. These cases highlight important anaesthetic considerations in SVP, including the role of dexmedetomidine as premedication, careful titration of anaesthetic agents to achieve haemodynamic goals, particularly in reducing pulmonary vascular resistance, the potential to omit muscle relaxants, goal-directed fluid therapy, and the importance of smooth extubation.
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