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咪达唑仑和丙泊酚用于种植手术镇静期间血糖水平变化的比较:一项前瞻性随机临床试验。

Comparison of the changes in blood glucose level during sedation with midazolam and propofol in implant surgery: a prospective randomized clinical trial.

作者信息

Kaviani Nasser, Koosha Farzad, Shahtusi Mina

机构信息

Dept. of Anesthesiology, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.

Student, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

J Dent (Shiraz). 2014 Sep;15(3):135-9.

Abstract

STATEMENT OF THE PROBLEM

Reducing the patients' stress can prevent, or at least, limit the increase in blood glucose level.

PURPOSE

The study compares the effect of propofol and midazolam on blood glucose level in the patients undergoing dental implant surgery. The effect of pre-operational stress on blood glucose level during the surgery is also evaluated.

MATERIALS AND METHOD

This prospective randomized clinical trial recruited 33 patients undergoing dental implant surgery and divided into two groups. Conscious sedation was performed by midazolam in one group and with propofol in another group. The pre-operational stress was scored and the blood glucose level was measured in 4 different stages; before the operation, two minutes after the local anesthetic injection; thirty minutes after the onset of operation and at the end of the operation. The results were analyzed by employing ANOVA and Pearson test. The p Value was adopted 0.05 and the confidence coefficient was assumed 95%.

RESULTS

The average levels of the blood glucose in midazolam and propofol group were 93.82 mg/dl and 94 mg/dl before the operation which displayed a meaningful increase of blood glucose level in both groups as the operation went on. The values were 103.76 mg/dl for midazolam and 108.56 mg/dl for the propofol group (p< 0.05) at the end of the operation. No statistically significant difference was found in the average blood glucose level between two groups in the different stages of the operation (p= 0.466). The Pearson correlation coefficient test revealed a higher increase in the blood glucose level in the patients with a higher pre-operational stress score (r= 0.756, p< 0.001).

CONCLUSION

Based on the results yielded by this study, patients who receive venous sedation, either by midazolam or propofol, experience increase in the blood glucose level while undergoing an operation. No statistically significant difference was detected between midazolam and propofol.

摘要

问题陈述

减轻患者的压力可以预防,或者至少限制血糖水平的升高。

目的

本研究比较丙泊酚和咪达唑仑对接受牙种植手术患者血糖水平的影响。同时评估术前应激对手术期间血糖水平的影响。

材料与方法

这项前瞻性随机临床试验招募了33例接受牙种植手术的患者,并将其分为两组。一组使用咪达唑仑进行清醒镇静,另一组使用丙泊酚。对术前应激进行评分,并在4个不同阶段测量血糖水平,分别为手术前、局部麻醉注射后两分钟、手术开始后30分钟和手术结束时。采用方差分析和Pearson检验对结果进行分析。采用p值为0.05,置信系数为95%。

结果

咪达唑仑组和丙泊酚组术前血糖平均水平分别为93.82mg/dl和94mg/dl,随着手术进行,两组血糖水平均有显著升高。手术结束时,咪达唑仑组为103.76mg/dl,丙泊酚组为108.56mg/dl(p<0.05)。在手术的不同阶段,两组之间的平均血糖水平无统计学显著差异(p=0.466)。Pearson相关系数检验显示,术前应激评分较高的患者血糖水平升高幅度更大(r=0.756,p<0.001)。

结论

基于本研究结果,接受咪达唑仑或丙泊酚静脉镇静的患者在手术期间血糖水平会升高。咪达唑仑和丙泊酚之间未检测到统计学显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d3eb/4149896/345f867cdc90/jds-15-135-g001.jpg

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