笑气吸入镇静系统在咽反射敏感患者根管治疗中的应用

Application of nitrous oxide inhalation sedation for patients with pharyngeal reflex sensitivity in root canal therapy

目的:探究咽反射敏感患者根管治疗中引入笑气吸入镇静系统的治疗效果。方法:将98例采用根管治疗的咽反射敏感患者纳入研究。根据采用镇痛方式的不同划分为实验组(50例)和对照组(48例),实验组给采用笑气吸入镇静技术,对照组采用盐酸丁卡因胶浆局部涂抹方法。观察两组患者术前、术后的生理指征、咽反射敏感性情况,记录耐受性及肌肉紧张程度。结果:实验组患者术前、术后各指标无统计学差异(P>0.05);对照组患者术后心率(HR)、舒张压(DBP)较术前均显著降低,视觉模拟评分法(visual analogue scale,VAS)评分较术前显著升高,差异均具有统计学意义(P<0.05)。实验组抑制咽反射有效率显著高于对照组,差异具有统计学意义(P<0.05)。实验组患者较对照组患者具有更好的耐受性,肌肉放松患者显著多于对照组,肌肉重度紧张患者显著少于对照组,差异均具有统计学意义(P<0.05)。结论:笑气吸入镇静系统能稳定生理指征、减低咽反射敏感性、提高耐受性并缓解患者紧张程度,是咽反射敏感患者的有效镇静方式。

Objective:To explore the role of application of nitrous oxide inhalation sedation for patients with pharyngeal reflex sensitivity in root canal therapy.Methods:Totally 98 patients with pharyngeal reflex sensitivity using root canal therapy in hospital from May 2016 to November 2018 were selected.All patients were divided into experiment group(50 cases)and control group(48 cases)according different analgesic methods.The experiment group used nitrous oxide inhalation sedation,and the control group used tetracaine hydrochloride jelly.The physiological indications and sensitivity of pharyngeal reflex in two groups were observed,and the tolerance and muscle tension during operation in two groups were recorded.Results:Before and after operation,the physiological indications in experiment group had no significant difference(P>0.05).HR and DBP levels in control group were significant lower than those of prior treatment,and VAS scores were significant higher than that of prior treatment,with statistical significance(P<0.05).The inhibition rate of pharyngeal reflex sensitivity in experiment group was higher than that of control group,with statistical significance(P<0.05).Compare to control group,the experiment group had better tolerance.Patients with muscular relaxation in experiment group was more than that of control group,and severe muscle tension was less than that of control group with statistical significance(P<0.05).Conclusion:The nitrous oxide inhalation sedation can stabilize physiological indications,reduce sensitivity of pharyngeal reflex,improve tolerance and relieve tension,which is a effective method of sedation for the patients with pharyngeal reflex sensitivity.