When managing ‘patients with COPD who are receiving corticosteroids are treated, the dentist should consider the me of additional supplementation before major surgery. Sedatives, hypnotics, and narcotics that depress
respiration should be avoided. Patients may need to be kept in an upright sitting position in the dental chair to enable them to better handle their commonly copious pulmonary secretions. Finally, supplemental oxygen during surgery should not be used in patients with severe COPD unless the physician advises it. In contrast with healthy people in whom an elevated arterial CO, level is the major stimulation to breathing, the patient with
CO PO becomes acclimated to elevated arterial CO, levels and comes to depend entirely on depressed arterial oxygen levels to stimulate breathing. If the arterial oxygen concentration is elevated by the administration of oxygen in a high concentration, the hypoxia-based respiratory
stimulation is removed and the patient’s respiratory rate may become critically slowed (Box 1-14).