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口服咪达唑仑与口服曲马多、三氯福司和唑吡坦用于儿科牙科患者镇静的比较:一项体内研究。

Comparison of oral midazolam with oral tramadol, triclofos and zolpidem in the sedation of pediatric dental patients: an in vivo study.

作者信息

Bhatnagar S, Das U M, Bhatnagar G

机构信息

Department of Pedodontics and Preventive Dentistry, Jodhpur Dental College General Hospital, Rajasthan, India.

出版信息

J Indian Soc Pedod Prev Dent. 2012 Apr-Jun;30(2):109-14. doi: 10.4103/0970-4388.99980.

Abstract

OBJECTIVE

oral sedation is the simplest and most convenient sedation method for managing uncooperative child patients because it is easy to administer and there is no need for nasal hood or injection. Oral midazolam is the most commonly used preanesthetic medication for children. When given in amounts between 0.5 and 0.75 mg/kg of body weight, oral midazolam has been found to be an effective sedative agent for pediatric outpatients. Tramadol is a synthetic, centrally acting analgesic indicated for moderate to severe pain. Chloral hydrate is one of the sedatives most commonly used, has excellent absorption, fast induction, and exert minimal effects on respiration. zolpidem is the most commonly prescribed hypnotic due to its clinical efficacy, safety, and ability to be well tolerated with patients.

MATERIALS AND METHODS

60 anxious and fearful children who reported to the department were treated under conscious sedation for the accomplishment of dental treatment. Patients were randomly assigned to four groups. Statistical analysis was done using Kruskal Wallis Test and decision criterion was to reject the null hypothesis if the P-value is less than 0.05.

RESULTS

it was observed that there is a statistically significant difference in median scores recorded for the level of sedation between the different groups (P < 0.001).

CONCLUSION

this study concluded that midazolam is the best drug for producing conscious sedation followed by tramadol and triclofos. Zolpidem was not able to produce a sufficient level of sedation and it cannot be supported as a sedative agent at the present dosage.

摘要

目的

口服镇静是管理不合作儿童患者最简单、最方便的镇静方法,因为其易于给药,且无需鼻罩或注射。口服咪达唑仑是儿童最常用的麻醉前用药。当按体重0.5至0.75毫克/千克的剂量给药时,口服咪达唑仑已被发现是儿科门诊患者有效的镇静剂。曲马多是一种合成的中枢性镇痛药,用于中度至重度疼痛。水合氯醛是最常用的镇静剂之一,具有良好的吸收性、快速诱导性,且对呼吸影响极小。唑吡坦因其临床疗效、安全性以及患者耐受性良好,是最常开具的催眠药。

材料与方法

60名到该科室就诊的焦虑恐惧儿童在清醒镇静下接受牙科治疗。患者被随机分为四组。采用Kruskal Wallis检验进行统计分析,决策标准是如果P值小于0.05则拒绝原假设。

结果

观察到不同组之间镇静水平记录的中位数得分存在统计学显著差异(P < 0.001)。

结论

本研究得出结论,咪达唑仑是产生清醒镇静效果最佳的药物,其次是曲马多和三氯福司。唑吡坦无法产生足够的镇静水平,目前剂量下不能作为镇静剂使用。

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