笑气吸入清醒镇静法在阻生牙拔除术中的临床观察

Clinical effects of nitrous oxide inhalation conscious sedation on extraction of impacted teeth

目的观察笑气吸入清醒镇静法在阻生牙拔除术中的临床应用效果。方法 40例需拔除下颌第3磨牙的患者按随机数字表法分为实验组和对照组,每组20例;实验组采用笑气吸入清醒镇静加局麻法拔牙,对照组采用常规局麻法拔牙,记录两种方法的拔牙完成时间,收缩压(SBP)、舒张压(DBP)、心率(HR)和脉搏氧饱和度(SpO2)变化,并进行疼痛程度(VAS评分)和镇静程度(Ramsay评分)的观察。结果实验组拔牙时间缩短,SBP、DBP、HR、SpO2变化平稳,疼痛程度减轻,局麻和手术时VAS分别为(1.10±0.72)、(1.75±0.64);镇静程度增强,术前和术中Ramsay分别为(2.55±0.51)、(2.35±0.48),与对照组比较均有显著统计学差异(P<0.05)。结论笑气吸入清醒镇静法在阻生牙拔除术中具有安全、有效等特点,值得临床推广应用。

Objective To observe the clinical effects of nitrous oxide inhalation conscious sedation on extraction of impacted teeth.Methods Forty patients,whose mandibular third molars needed extraction,were randomly divided into an experimental group（n=20） and a control group（n=20）.The patients in the experimental group were subjected to extraction of impacted teeth under nitrous oxide inhalation conscious sedation and local anesthesia,while the patients in the control group were subjected to extraction of impacted teeth under routine local anesthesia.The duration of tooth extraction and the changes of systolic blood pressure（SBP）,diastolic blood pressure（DBP）,heart rate（HR）,and pulse oxygen saturation（SpO2） were recorded.The pain levels and sedation effects were analyzed with visual analogue scale（VAS） and Ramsay scale.Results The duration of tooth extraction in the experimental group was significantly shorter than that of the control group（19.90±2.11 min vs 22.85±2.54 min,P0.05）.SBP,DBP,HR,and SpO2 changed more smoothly in the experimental group than in the control group.The local anesthesia and intraoperative VAS scores in the experimental group were significantly lower than those in the control group（1.10±0.72 and 1.75±0.64 vs 2.35±0.87 and 3.25±0.55,P0.05）,indicating reduced pain levels.The preoperative and intraoperative Ramsay scores in the experimental group were significantly higher than those in the control group（2.55±0.51 and 2.35±0.48 vs 1.55±0.51 and 1.35±0.49,P0.05）,indicating increased sedation effects.Conclusion Nitrous oxide inhalation conscious sedation is safe and effective in extraction of impacted teeth.