无痛口腔注射仪在伴有牙科焦虑症的心血管病患者麻醉中的应用研究

Study on Application of Oral Painless Injection Device in the Anesthesia of Dental Anxiety Patients with Cardiovascular Disease

目的:观察在伴有牙科焦虑症的心血管病患者麻醉过程中,采用无痛口腔局麻注射仪对其血压、心率及疼痛指标的影响。方法:通过改良的牙科焦虑量表(DAS),筛选出需要拔牙的264例伴有牙科焦虑症的心血管病患者,随机分为无痛口腔局麻注射组和常规局麻注射组,通过心电监护仪采集麻醉前后的血压、心率数值,并用视觉模拟标尺法(VAS)让患者评价疼痛程度,对数据进行统计学分析。结果:两组患者均顺利完成手术;无痛注射组麻醉前后的收缩压、舒张压、心率差异有统计学意义(P<0.05);常规注射组麻醉前后的收缩压、舒张压、心率的差异有统计学意义(P<0.05);无痛注射组患者的疼痛值明显低于常规注射组(P<0.01)。结论:对伴有牙科焦虑症的心血管病患者使用无痛口腔局麻注射仪时,虽然疼痛值显著降低,但血压、心率值变化仍较明显,为防止心脑血管意外发生,还需联合其他辅助措施共同治疗。

Objective:To observe the effect of the painless oral local anesthesia apparatus on blood pressure, heart rate and the pain index in patients with a history of cardiovascular disease as well as dental anxiety during the process of anesthesia. Methods:264 patients with both cardiovascular disease and dental anxiety were selected according to a modified dental anxiety score(DAS). Patients were divided into painless oral local anesthesia apparatus group and conventional local anesthesia group randomly.The diastolic pressure and heart rate of each patient were recorded with electrocardiogram monitor. The degree of pain was assessed with visual analogue scale(VAS). Data was analyzed with statistical analysis. Results:Surgeries were completed successfully. There is a significant difference between pre-anesthesia and post-anesthesia in systolic pressure, diastolic pressure and heart rate in painless oral local anesthesia group(p<0.05). In conventional local anesthesia group, the difference between pre-anesthesia and post-anesthesia in systolic pressure, diastolic pressure and heart rate was significant(p<0.05). The pain value of painless injected group was less than the conventional injection(P<0.01). Conclusion:Though painless oral local anesthesia apparatus can significantly decrease pain value for patients with cardiovascular disease as well as dental anxiety,the pressure blood and heart rate of patients would change obviously. In order to prevent the accident of cardiovascular and cerebrovascular disease, other auxiliary measures should also be taken in the treatment.