靶控输注异丙酚复合瑞芬太尼镇静在牙科恐惧症患者及非牙科恐惧症患者中应用的比较

Comparison of target-controlled infusion of propofol combined with remifentanil in patients with dental phobia and non-dental phobia

目的比较靶控输注异丙酚复合瑞芬太尼镇静在牙科恐惧症患者和非牙科恐惧症患者第三磨牙拔除手术中应用的效果及用药量。方法用改良牙科焦虑量表进行评分,将择期接受第三磨牙拔除手术的患者分为牙科恐惧症组(A组,n=30)和非牙科恐惧症组(C组,n=30)。两组患者靶控输注瑞芬太尼目标浓度为1ng/ml,滴定法靶控输注异丙酚至OAA/S评分3分时进行手术。记录患者的心率、血压、血氧饱和度和呼吸频率和NI指数,相关并发症或相关反应情况、药物输注情况以及术后患者满意度。结果两组患者的心率、血压、血氧饱和度和呼吸频率和NI指数,相关并发症或相关反应情况、药物输注情况以及术后患者满意度均无差异(P>0.05)。结论牙科恐惧症患者和非牙科恐惧症患者在第三磨牙拔除术应用靶控输注异丙酚复合瑞芬太尼镇静均能达到满意效果,而且用药量无差异。

Objective To compare the effect and dose in the sedation titrated under target-controlled infusion of propofol -remifentanil for the extraction of third molars in patients with dental phobia and non-dental phobia. Methods Sixty patients scoring with the Improved Dental Anxiety Scalewere for third molar surgery were divided into two groups : group A (dental phobia group, n = 30) and group C (non-dental phobia group, n = 30). A infusion of remifentanil with a target plasma concentration of 1 ng/ml and a titrated infusion of propofol was started until the OAA/S score had reached level 3. Then the surgery began. In all patients, the heart rate, blood pressure, respiratory rate, oxyhemoglobin saturation and narcotrend index were recorded during the operation. The reactions of the patients in the operation and the data of propofol infusion were recorded.The satisfactions of the patients were asked. Results The heart rate, blood pressure, respiratory rate, oxyhemoglobin saturation, narcotrend index, the reactions of the patients and the data of propofol infusion in two groups were no significant difference (P>0.05). Conclusion The sedation titrated under target -controlled infusion of propofol or propofol -remifentanil for the extraction of third molars in patients with dental phobia and nondental phobia is satisfactory. Moreover, there is no difference in the amount of medication.