Division of Oral Implantology, Department of Oral Health and Clinical Science, Tokyo Dental College, Suidoubashi Hospital, Japan.
Int J Oral Maxillofac Implants. 2011 Nov-Dec;26(6):1303-8.
The purpose of the present study was to determine whether intravenous sedation during dental implant surgery contributed to stabilization of hemodynamics.
Two hundred fifty-five consecutive patients treated with dental implants were randomly assigned to receive either intravenous sedation with local anesthesia (sedation group, n = 123) or local anesthesia only (nonsedation group, n = 132). Midazolam and propofol were used synergistically as sedative agents. Systolic blood pressure, diastolic blood pressure, and pulse rate were measured every 2.5 minutes during dental implant surgery. On the basis of these data, the coefficient of variation, percentage of change, maximum values, and incidences of a larger increase were analyzed and expressed as cardiovascular changes.
A comparison of percentages of change, maximum values, and incidences of a greater increase showed that systolic and/or diastolic blood pressure were significantly higher in the nonsedation group than in the sedation group. The combination of midazolam and propofol sedation prevented excessive increases in blood pressure. The circulatory suppression induced by the intravenous sedation regimen not only reduced mental stress arising from the state of sedation but also exerted a pharmacologic effect. The application of this intravenous sedation regimen stabilized hemodynamics and contributed to the safety of the patient in dental implant surgery.
The application of intravenous sedation had a beneficial effect for hemodynamic changes during dental implant surgery.
本研究旨在确定在牙科种植手术中进行静脉镇静是否有助于稳定血流动力学。
将 255 例接受牙科种植治疗的连续患者随机分为接受局部麻醉静脉镇静组（镇静组，n = 123）或仅接受局部麻醉组（非镇静组，n = 132）。咪达唑仑和丙泊酚联合作为镇静剂。在牙科种植手术过程中，每 2.5 分钟测量一次收缩压、舒张压和脉搏率。基于这些数据，分析和表示心血管变化的变化系数、变化百分比、最大值和较大增加的发生率。
比较变化百分比、最大值和较大增加发生率的结果表明，非镇静组的收缩压和/或舒张压明显高于镇静组。咪达唑仑和丙泊酚联合镇静可防止血压过度升高。静脉镇静方案引起的循环抑制不仅减轻了镇静状态引起的精神压力，而且还发挥了药理作用。这种静脉镇静方案的应用稳定了血流动力学，有助于患者在牙科种植手术中的安全。
在牙科种植手术中应用静脉镇静对血流动力学变化有有益的影响。
