TCI异丙酚镇静在牙科畏惧症小儿拔牙术的应用

Application of target controlled infusion propofol sedation in dental fear children for dental extraction

目的:观察56例牙科畏惧症小儿行拔牙手术时采用靶控输注(target controlled infusion,TCI)异丙酚镇静的效果,探讨靶控输注镇静剂方式在牙科畏惧症小儿拔牙时的安全性及适用性。方法:56例牙科畏惧症拔牙小儿静脉TCI异丙酚,血浆靶控浓度设定为1.5μg/ml,测定镇静后拔牙时小儿心率(HR)及脉搏氧(SpO2),并测量镇静值,与拔牙前测量值进行比较。结果:小儿在拔牙时的HR轻度下降,SpO2在实施TCI镇静剂前后无显著变化,小儿均处于中度镇静状态,Ramsay镇静评分5.2±0.8,镇静评分前后比较有显著意义。结论:TCI镇静技术用于小儿牙科畏惧症拔牙术具有良好的镇静效果,对呼吸及循环系统无明显影响,适用于小儿拔牙术中畏惧症的控制和治疗。

Objective： To observer the sedative effects in 56 dental fear children who were treated by target controlled infusion propofol for teeth extractions. Methods： Sedation in 56 dental fear children was induced by target controlled infusion of propofol and the predicted drug concentration was 1.5 μg/ml. The HR, SpO2 and scores of sedation were measured and compared before and after TCI sedation. Results： Heart rates of the patients decreased slightly during operation, but there was no significant changes in heat rate and SpO2 before and after TCI sedation. Children were on the middle sedation states. Ramsay sedation score was 5.2 ± 0.8, which was significantly different compared with that before TCI sedation. Conclusion： Target controlled infusion propofol sedation in dental fear children for dental extractions is effective, which has no obvious impact on respiration and circulation system. It is feasible in the management and treatment of dental fear during teeth extraction.