口服咪达唑仑用于小儿口腔修复术中清醒镇静的评估。

Evaluation of oral midazolam as conscious sedation for pediatric patients in oral restoration.

作者信息

Wan Kuo, Jing Quan, Zhao Ji-zhi

机构信息

Department of Endodontics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730.

出版信息

Chin Med Sci J. 2006 Sep;21(3):163-6.

PMID:17086737

Abstract

OBJECTIVE

To evaluate the effect of midazolam alone on sedation in young children for dental restorative care.

METHODS

Forty children, aged 5 to 10 years with a mean age of 7.3 years, participated in this study. Twenty-one patients were assigned to intervention group received 0. 5 mg/kg of oral midazolam 20 minutes prior to the beginning of dental treatment, and 19 patients in control group received placebo liquid 20 minutes before treatment All patients received painless local anesthetic injection and were restrained with children's board and bands. Blood pressure (BP), heart rate (HR), oxygen saturation, treatment compliance scores of the Ramsay scale, the Briekopf and Buttner scale, Frankl scale, and the Houpt scale were recorded. Each procedure was taped and all the data were evaluated every 5 minutes by an anesthetist or experienced dentist who was unaware of the drug given to the child.

RESULTS

HR in intervention group (82.5 +/- 5.1 bpm) was much lower than that in control group (95.2 +/- 8.9 bpm; F = 31.20, P < 0.001). Intervention group had a significantly lower systolic BP level (94.8 +/- 5.6 mm Hg) than control group (98.5 +/- 5.5 mm Hg; F = 4.34, P = 0.04), but the diastolic BP (63.0 +/- 3.5 mm Hg) was not significantly lower than control group (65.5 +/- 4.8 mm Hg; F = 3.31, P = 0.07). Children in intervention group showed more compliance. The patients' scores of the Ramsay scale, Briekopf and Buttner scale, Frankl scale, and Houpt scale in intervention group (1.37 +/- 0.96, 1.37 +/- 0.83, 1.32 +/- 0.67, and 2.32 +/- 1.49, respectively) were significantly lower than those in control group (3.71 +/- 1.23, 2.71 +/- 0.96, 2.71 +/- 0.90, and 4.71 +/- 1.19; F = 44.66, 22.36, 30.39, and 31.88, respectively, all P < 0.001).

CONCLUSIONS

Oral midazolam alone is safe and produces effective sedation for the dental treatment of young children. Oral midazolam application should be generally preferred because it is more easily accepted by pediatric patients.

摘要

目的

评估单用咪达唑仑对幼儿牙科修复治疗镇静的效果。

方法

40名年龄在5至10岁、平均年龄7.3岁的儿童参与了本研究。21例患者被分配至干预组，在牙科治疗开始前20分钟口服0.5mg/kg咪达唑仑，19例对照组患者在治疗前20分钟接受安慰剂液体。所有患者均接受无痛局部麻醉注射，并用儿童板和束带约束。记录血压（BP）、心率（HR）、血氧饱和度、Ramsay量表、Briekopf和Buttner量表、Frankl量表以及Houpt量表的治疗依从性评分。每个操作过程都进行录像，由一名不知道给孩子使用何种药物的麻醉师或经验丰富的牙医每5分钟评估一次所有数据。

结果

干预组的心率（82.5±5.1次/分钟）远低于对照组（95.2±8.9次/分钟；F = 31.20，P < 0.001）。干预组的收缩压水平（94.8±5.6mmHg）显著低于对照组（98.5±5.5mmHg；F = 4.34，P = 0.04），但舒张压（63.0±3.5mmHg）并不显著低于对照组（65.5±4.8mmHg；F = 3.31，P = 0.07）。干预组的儿童表现出更高的依从性。干预组患者的Ramsay量表、Briekopf和Buttner量表、Frankl量表以及Houpt量表评分（分别为1.37±0.96、1.37±0.83、1.32±0.67和2.32±1.49）显著低于对照组（3.71±1.23、2.71±0.96,、2.71±0.90和4.71±1.19；F分别为44.66、22.36、30.39和31.88，均P < 0.001）。