Lu Dominic P, Wu Ping-Shi, Lu Winston I
University of Pennsylvania, USA.
Acupunct Electrother Res. 2012;37(1):49-62. doi: 10.3727/036012912x1383183125612.
Treating apprehensive debilitated patients (i.e. geriatric patients, patients with cardiac, pulmonary, kidney, or liver diseases, and those with other severe systemic conditions) for dental procedures can cause unexpected medical complications such as cardiac arrest, stroke, asthma or shock, etc. Due to diminishing functional capacities of their organs, sedating those patients with sedative drugs in normal regular dosage could increase the risk of adverse events for this group of patients and can also increase the risk of liability for the clinician. The authors treated 34 apprehensive dental patients with a combination technique using parenteral sedation and hypnosis together with acupuncture. We used Bi-Digital O-Ring Test (BDORT) to select the compatible sedative drugs and to individualize the dosage suitable to the patient's medical condition. Oftentimes, BDORT predetermined dosage amounts to a fraction of regular dosage that is normally recommended by manufacturer for regular healthy patients. Such a reduced dosage, though benign to patient, may be insufficient to render a patient to the sedation level for dental treatment. Nevertheless, hypnosis with acupuncture can be applied to potentiate the therapeutic effect of parenteral sedation, thereby reducing the amount of sedative agents required to alleviate patient anxiety. The results indicated that hypnosis with acupuncture and BDORT could effectively allow the reduction of the sedative dosage and may beneficially provide a safe and comfortable situation for the debilitated patients to receive the necessary treatment.
为焦虑的虚弱患者(即老年患者、患有心脏、肺部、肾脏或肝脏疾病的患者以及患有其他严重全身性疾病的患者)进行牙科手术可能会引发意想不到的医疗并发症,如心脏骤停、中风、哮喘或休克等。由于这些患者器官功能逐渐衰退,使用常规剂量的镇静药物对其进行镇静可能会增加该组患者发生不良事件的风险,同时也会增加临床医生承担责任的风险。作者采用胃肠外镇静、催眠与针灸相结合的技术治疗了34例焦虑的牙科患者。我们使用双指O形环测试(BDORT)来选择合适的镇静药物,并根据患者的病情确定个体化剂量。通常情况下,BDORT预先确定的剂量仅为制造商通常推荐给正常健康患者的常规剂量的一小部分。这样减少的剂量虽然对患者无害,但可能不足以使患者达到牙科治疗所需的镇静水平。然而,针灸催眠可以增强胃肠外镇静的治疗效果,从而减少缓解患者焦虑所需的镇静剂用量。结果表明,针灸催眠和BDORT可以有效地减少镇静剂用量,并可能有益地为虚弱患者提供一个安全舒适的环境,使其能够接受必要的治疗。