Managing Shock During Dental Surgery: A Step-by-Step Guide

Managing Shock During Dental Surgery: A Step-by-Step Guide

Question. Write short note on the management of shock while doing dental surgery.

Answer. In such case there following shock occurs:

Neurogenic Or Vasovagal Shock

• This is a response to sudden fear or severe pain and the effcts from slight fainting fi to death.
• This type of shock is also known as neurogenic or psychogenic shock.
• There is sudden pooling of blood in the capacitance vessels of legs and splanchnic arterial bed. This causes hypoxia of vital center.

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Clinical Features

• History of emotional stress or pain of a sudden nature.
• Bradycardia or pallor.
• Tachypenia
• Fainting
• Reflxes are usually intact.

Management

• Place the patient flt or in head low position.
• Ensure potency of airway
• IV atropine may be needed for persistent or increasing bradycardia.

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Hypovolemic shock, i.e. Hemorrhagic shock

Management

• Control hemorrhage.
• IV flid is to restore circulating blood volume.
• Blood transfusion.
• Rising of foot end of bed.
• Oxygen inhalation.
• If acidosis develops. Sodium bicarbonate is infused till pH is normalized.
• Recovery is indicated by improvement in consciousness, dry and warm skin, CVP is more then 5 cm of H2O,distended veins and increased in urinary output.