肌注咪达唑仑在孤独症儿童口腔治疗中的应用

The effectiveness of intramuscular midazolam sedation for autistic pediatric patients in dental treatment

目的:评估孤独症患儿在肌注咪达唑仑镇静下口腔治疗的效果。方法:选择Frankl量表评分1分的孤独症患儿,共进行30例肌注咪达唑仑(0.20 mg/kg)镇静下口腔治疗。记录患儿镇静和治疗相关数据,并于24 h后回访患儿不良反应及家长满意度。结果:所有患儿生命体征平稳,未出现严重不良反应,28例(93.3%)完成了既定治疗,26例(86.7%)镇静成功。药物起效时间(15.11±2.53)mins,治疗持续时间(35.20±12.07)mins。镇静成功率与年龄、性别、治疗难易程度、口腔治疗史均无关,但6岁以上患儿镇静效果更好。82.8%患儿家长对镇静效果满意,90%的家长愿意再次接受镇静下治疗。结论:对于孤独症患儿,肌注咪达唑仑镇静技术易于操作、安全、有效且患儿家长满意度高,可以作为辅助其完成口腔治疗的选择。

Objective:To evaluate the sedative effectiveness of intramuscular midazolam sedation for autistic pediatric patients in dental treatment.Methods:Thirty cases of intramuscular midazolam(0.20 mg/kg) sedation were administrated before dental treatment to autistic children who were classified as 1 by Frankl behaviour rating scale. Data related to sedation and treatment were recorded, and telephone following-ups were performed 24 hours after treatment to record the side effects and parents’ satisfaction.Results:In all of the 30 treatments, the children’s vital signs were stable and no severe complications occurred. Twenty-eight(93.3%) treatments were completed while 26(86.7%) with successful sedation. The onset time of midazolam was(15.11±2.53) minutes, and the duration of treatment was(35.20±12.07) minutes. The success rate of sedation had no relationship with age, sex, the difficulty of treatment, or dental treatment history, while children older than 6 performed better. Conclusion:Intramuscular midazolam sedation could be a safe, effective and acceptable approach for pediatric dental patients with serious autism.