Juodzbalys Gintaras, Giedraitis Rimvydas, Machiulskiene Vita, Huys Luc W J, Kubilius Ricardas
Department of Maxillofacial Surgery, Kaunas University of Medicine, Lithuania.
J Oral Implantol. 2005;31(6):304-8. doi: 10.1563/0-771.1.
Local anesthesia, the well-known method of sedation, usually is insufficient for dental implantation and the augmentation of the alveolar ridge, because the operations last for 1 to 2 hours and patients may experience fear and strain. This article examines a new complex sedation method using ketorolac, midazolam, and a local anesthetic 4% solution of articaine hydrochloride and epinephrine (Septanest) in combination with a vasoconstrictor. This method was applied to 67 patients operated on for dental implantation with screw implants or for the alveolar ridge augmentation with biocompatible materials. The control group, which consisted of 20 patients, received local anesthesia with articaine-epinephrine only. Most of the control patients were found to have experienced fear and strain during the aforementioned surgical procedures; their blood pressure and pulse rate increased, and more than half of them experienced pain. No disorders of hemodynamics or the psychoemotional status of the patients were observed during sedation with ketorolac, midazolam, and articaine-epinephrine. Furthermore, anterograde amnesia was determined for the 80% of the patients in the test group.
局部麻醉作为一种广为人知的镇静方法,通常不足以用于牙种植和牙槽嵴增量手术,因为这些手术持续1至2小时,患者可能会感到恐惧和紧张。本文探讨了一种新的复合镇静方法,该方法使用酮咯酸、咪达唑仑以及含4%盐酸阿替卡因和肾上腺素的局部麻醉剂溶液(Septanest)并联合使用血管收缩剂。该方法应用于67例接受种植体植入或使用生物相容性材料进行牙槽嵴增量手术的患者。对照组由20例患者组成,仅接受阿替卡因 - 肾上腺素局部麻醉。结果发现,大多数对照组患者在上述手术过程中经历了恐惧和紧张;他们的血压和脉搏率升高,超过一半的患者感到疼痛。在使用酮咯酸、咪达唑仑和阿替卡因 - 肾上腺素进行镇静期间,未观察到患者的血流动力学或心理情绪状态出现紊乱。此外,试验组80%的患者出现了顺行性遗忘。