咪达唑仑静注在儿童埋伏多生牙拔除术中的应用

The evaluation of clinical effects of intravenous injection midazolam sedation in supernumerary tooth extraction of children

目的探讨在日间门诊手术室咪达唑仑静脉镇静状态下拔除儿童上颌埋伏多生牙的临床效果。方法选择在郑州人民医院口腔科门诊就诊拔除上颌埋伏多生牙的7～14岁患儿13名,美国麻醉医师协会分级Ⅰ级,咪达唑仑静注到中度镇静,在局麻下进行拔牙手术,监测患儿生命体征。结果患儿的生命体征平稳,年龄和体重、用药总量的关系呈正相关,差异有统计学意义(P<0.05);年龄与用药剂量之间呈负相关,差异有统计学意义(P<0.05)。年龄对局部麻醉注射、及手术过程的记忆有影响,差异无统计学意义(P>0.05)。所有病例手术顺利并安全离院,离院标准评分均在12分以上,术后回访显示大部分患儿出现不同程度的顺行性遗忘。结论在日间门诊手术室采用咪达唑仑静脉镇静配合口腔局部注射麻醉拔除儿童上颌埋伏多生牙是安全有效的方法。

Objective To investigate the clinical effect in the daytime out-patient operation room midazolam intravenous sedation extracted maxillary impacted supernumerary teeth in children.Methods 13 patients age range of 7～ 14 with maxillary impacted supernumerary teeth were selected to be carried tooth extraction operation under local anesthesia,midazolam intravenous injection to moderate sedation,graded I by American Society of Anesthesiology（ASA）,Vital signs of patients were monitored.Results The vital signs of patients were stable,the age and weight were the positive correlated with cumulate dosage,P value of 0.05 were considered statistically significant;the age were negatively correlated with doses,P value of 0.05 were considered statistically significant.The age have the effect on local anesthetic injection and the memory for operation incision,P value of 0.05 were not considered statistically significant.All cases were operation smoothly and safely discharged,and all the standard score of discharged were more than 12 points,most patients had the postoperative anterograde amnesia in different degree.Conclusion Using midazolam intravenous sedation extracted maxillary impacted supernumerary teeth in children is safe and effective in the daytime out-patient operation room.