不同静脉镇静程度在阻生智齿拔除手术中的临床效果比较

Comparison of effects of different intravenous sedation degrees in mandibular third molar operation

目的评价不同咪达唑仑静脉镇静程度在口腔治疗焦虑病人阻生智齿拔除术中的有效性、安全性和实用性的差异。方法运用自身对照研究,入选病人双侧智齿需要拔除且难度相当,门诊进行治疗,每个病人首先随机的采用咪达唑仑静脉镇静较浅镇静程度拔除一侧智齿,1个月后,在较深的镇静程度下拔除另一侧智齿。评估指标包括病人的生命体征,医生的工作状态,镇静程度(OAA/S),病人主观对于疼痛和焦虑的评价(VASP、VASA)以及病人最终满意度评分。结果 23名病人的智齿均成功拔除。浅镇静组的药物剂量使用相对少。深镇静组则出现了更多的血氧饱和度低于95%的情况(P<0.05)。两组之间在医生操作满意度评分、VASA、VASP和病人最终满意度评分方面没有明显差异(P>0.05)。结论较浅的镇静程度保证了口腔治疗的安全性,在能够保证口腔治疗顺利完成的前提下,应尽量采用较浅的镇静程度辅助治疗。

Objective To evaluate and compare the clinical effectiveness, safety and practicability of differentmidazolam intravenous sedation degrees in mandibular third molar operation for dental fear patients. Methods In this selfcontrol trial, all patients had bilateral mandibular third molar which need surgical removal, and the difficulty of operationon both sides were similar. For each patient, randomly, on tooth was removed under light sedation degree, one monthlater, the other tooth was removed under deep sedation degree. The patients＇ vital signs, dentist＇s working conditions,patients＇ subjective evaluation to anxiety and pain during the procedures and final satisfaction were collected and comparedstatistically. Results 23 patients successfully managed throughout the experiment. There were no severe complicationsobserved. The light sedation degree group consumed less midazolam and the deep sedation degree group showed more SO2%descend below 95%（P〈0.05）. There were no difference about dentist＇s working conditions, patients＇ subjective evaluation toanxiety and pain during the procedures and final satisfaction between the groups（P〉0.05）. Conclusions Owning to its safety,the light sedation degree should be always preferred, once the dental treatment can be conducted favorably.