Sanadhya Y K, Sanadhya S, Jalihal S, Nagarajappa R, Ramesh G, Tak M
Department of Medicine, Jhalawar Hospital and Medical College, Jhalawar, India.
J Indian Soc Pedod Prev Dent. 2013 Jan-Mar;31(1):10-6. doi: 10.4103/0970-4388.112393.
Dental treatment induces pain anxiety and fear. This study was conducted to assess the changes in hemodynamic, ventilator, and electrocardiograph changes during extraction procedure among 12-15-year-old children and compare these changes with anxiety, fear, and pain.
A purposive sample of 60 patients selected based on inclusion and exclusion criteria underwent study procedure in the dental OPD of a medical college and hospital. The anxiety, fear, and pain were recorded by dental anxiety scale, dental fear scale, and visual analogue scale, respectively, before the start of the procedure. The systolic blood pressure, diastolic blood pressure, heart rate, oxygen saturation, and electrocardiogram changes were monitored during the extraction procedure. The recording was taken four times (preinjection phase, injection, extraction, and postextraction) and was analyzed.
At the preinjection phase the mean vales were systolic blood pressure (128 ± 11.2), diastolic blood pressure (85.7 ± 6.3), heart rate (79.7 ± 9.3), and oxygen saturation (97.9 ± 5.8). These values increased in injection phases and decreased in extraction phase and the least values were found after 10 min of procedure and this relation was significant for all parameters except oxygen saturation (P = 0.48, NS). ECG abnormalities were seen among 22 patients and were significant before and after injection of Local anesthetic (P = 0.0001, S).
Anxiety, fear, and pain have an effect on hemodynamic, ventilator, and cardiovascular parameters during the extraction procedure and hence behavioral management has to be emphasized among children in dental clinics.
牙科治疗会引发疼痛、焦虑和恐惧。本研究旨在评估12至15岁儿童拔牙过程中的血流动力学、通气和心电图变化,并将这些变化与焦虑、恐惧和疼痛进行比较。
根据纳入和排除标准选取60例患者作为有目的样本,在一所医学院校附属医院的牙科门诊接受研究程序。在手术开始前,分别用牙科焦虑量表、牙科恐惧量表和视觉模拟量表记录焦虑、恐惧和疼痛情况。在拔牙过程中监测收缩压、舒张压、心率、血氧饱和度和心电图变化。记录共进行四次(注射前阶段、注射、拔牙和拔牙后)并进行分析。
注射前阶段的平均值为收缩压(128±11.2)、舒张压(85.7±6.3)、心率(79.7±9.3)和血氧饱和度(97.9±5.8)。这些值在注射阶段升高,在拔牙阶段降低,且在手术10分钟后达到最低值,除血氧饱和度外,所有参数的这种关系均具有显著性(P = 0.48,无统计学意义)。22例患者出现心电图异常,在注射局部麻醉剂前后具有显著性(P = 0.0001,有统计学意义)。
焦虑、恐惧和疼痛在拔牙过程中会对血流动力学、通气和心血管参数产生影响,因此牙科诊所必须重视对儿童的行为管理。