肌内注射氯氨酮咪达唑仑镇静技术在儿童牙科门诊手术中的应用

Intr■r Ketamine and Midazolam for Pediatric Sedation in the Dental Surgery.

目的提出一种新的儿童牙科治疗镇静技术并评价其安全性和有效性。方法选择需要进行小的牙科门诊手术(舌系带延长术和小外伤缝合术)2～7岁的儿童37人采用镇静技术,给予氯氨酮(3mg/kg),咪达唑仑(0.05mg/kg)。必要时再给氯氨酮(1mg/kg)。术中术后观察心率、血压,呼吸频率,氧饱和度并记录药物副作用和评价患儿的治疗依从性。结果32名患儿在第一次注射后即取得了较好的镇静满意度。另外5名患儿在进行第2次注射后也取得了成功。一般注射后5分钟药物开始起效,持续时间大约半个小时,结论肌内注射氯氨酮和咪达唑仑是一种安全、有效的儿童牙科镇静技术。这一技术因其效果良好和易于推广而具有广阔的发展前景。

Objective The safety and efficacy of a new sedation for children dental treatment were prospectively evaluated.Methods Thirty -seven children between the ages of 2 years and 7 years who required sedation for dental clinic surgery(lingual frenum extension and minor oral surgery).These children were administered an intramuscular injection of ketamine(3mg/kg),midazolam(0.05mg/kg).A second 1mg intra- muscular injection of ketamine alone was given if needed.Cardiac rhythm,blood pressure,respiratory rate,oxygen saturation were recorded.Side effects and behavior were recorded and evaluated too.Results Satisfactory sedation were achieved after a single injection in 32 children;five oth- ers required a second ketamine(1mg/kg)injection.Onset of sedation occurred within 5 minutes generally,and there were adequate working con- dition for 30 minutes.Conclusion The use of intramuscular ketamine and midazolam is a safe,effective,and practical approach to managing den- tal pediatric treatment.It will be preferred because it is more easily accepted and effective by pediatric patients.