异丙酚清醒镇静术用于阻生齿拔除的临床观察

Conscious Sedation with Propofol during Extraction of the Impacted Teeth

目的 :观察异丙酚与局麻合用在阻生齿拔除术中的镇静、镇痛、遗忘作用并与加用氯铵酮对比。方法 :门诊成人阻生齿拔除 40例 ,随机分为异丙酚组 (P组 ,n =2 5 )和异丙酚加氯胺酮组 (PK组 ,n =15 )。首次量分别静注异丙酚 0 8～ 1 2mg/kg和异丙酚 0 6mg/kg加氯胺酮 0 2mg/kg ,此后持续静注异丙酚 ,以维持镇静 3级为度 ,2 %利多卡因行齿槽神经阻滞。结果 :术中两组均维持镇静 3级 ,术后VAS为 0。P组和PK组对手术操作遗忘分别为 80 %和10 0 % ,但PK组术后 46 6 6 %头晕 ,13 33%呕吐。结论 :异丙酚与局麻合用于阻生齿拔除可产生满意的镇静、镇痛、遗忘作用 。

Objective:To observe the effect of sedation and amnesia with propofol during extraction of the impacted teeth under local anesthesia.Methods:40 outpatients undergoing dental extraction were randomly assigned to receive either propofol 0 8 1 2mg/kg (group P, n= 25) or propofol 0 6 1mg/kg plus ketamine 0 2mg/kg (group PK, n= 15).Propofol was intravenously injected constantly in both groups in order to maintain sedation grade 3 2% lidocaine was used to perform nerve block.Results:Sedation grade 3 was achieved in both groups.VAS was zero postoperatively.amnesia was 80% in group P and 100% in group PK.But diziness and vomitting happened in group PK were 46 66% and 13 33% respectively.Conclusion:Consious sedation with propofol has a good effect on sedation,amnesia and psychologic protection in dental extraction.Side effect will become more when ketamine is added.