Faulks Denise, Hennequin Martine, Albecker-Grappe Sylvie, Manière Marie-Cécile, Tardieu Corinne, Berthet Annie, Wolikow Maryse, Droz Dominique, Koscielny Serge, Onody Peter
Service d'Odontologie, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.
Dev Med Child Neurol. 2007 Aug;49(8):621-5. doi: 10.1111/j.1469-8749.2007.00621.x.
Persons with intellectual disability have difficulty in cooperating with outpatient care, and many are referred for general anaesthesia. Intellectual disability has traditionally been a contraindication for conscious sedation. We evaluated the behavioural impact, effectiveness, and tolerance of sedation in this population using a fixed 50% nitrous oxide/oxygen mixture as a single agent. We used dental treatment as a model of outpatient care; 349 patients (192 males, 157 females; mean age 22y [SD 14]; range 3-81y) were recruited over a 12-month period at seven centres. Sedation was deemed successful if planned dental treatment was completed. Behaviour was scored with the modified Venham scale. Out of 605 sessions, 91.4% were successful. No serious adverse effects occurred. Minor adverse events (such as nausea) occurred in 10.1% of sessions. We conclude that the use of safe and effective conscious sedation may reduce the indications for general anaesthesia.
智障人士在接受门诊护理时存在困难，许多人因此需要接受全身麻醉。传统上，智障一直是清醒镇静的禁忌证。我们使用固定比例的50%氧化亚氮/氧气混合气体作为单一药物，评估了该人群镇静的行为影响、有效性和耐受性。我们将牙科治疗作为门诊护理的模型；在12个月的时间里，在7个中心招募了349名患者（192名男性，157名女性；平均年龄22岁[标准差14]；年龄范围3 - 81岁）。如果计划的牙科治疗完成，则认为镇静成功。使用改良的韦纳姆量表对行为进行评分。在605次治疗中，91.4%取得成功。未发生严重不良反应。10.1%的治疗出现轻微不良事件（如恶心）。我们得出结论，使用安全有效的清醒镇静可能会减少全身麻醉的指征。
