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全身麻醉下拔牙时气态诱导和静脉诱导对儿童焦虑和痛苦的影响。

Effectiveness of gaseous and intravenous inductions on children's anxiety and distress during extraction of teeth under general anesthesia.

作者信息

Gazal Giath, Fareed Wamiq M, Zafar Muhammad S

机构信息

Department of Restorative Dental Sciences, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia.

出版信息

Saudi J Anaesth. 2015 Jan;9(1):33-6. doi: 10.4103/1658-354X.146282.

Abstract

CONTEXT

Anxiety and distress regarding dental treatment is a major issue for dental patients and can be exaggerated in pediatric dental patients.

AIMS

The aim was to investigate how different methods of induction for general anesthesia affect children's distress for dental procedures such as extraction of teeth.

SUBJECTS AND METHODS

This was an observational clinical study conducted at Manchester University Dental Hospital. The induction of anesthesia in children was achieved with either intravenous (I.V.) or a gaseous induction. The Modified Child Smiley Faces Scales were completed for children at various times intervals.

STATISTICAL ANALYSIS USED

There were statistically significant differences between the mean distress scores for the I.V. and inhalation groups (P values from independent t-test: P < 0.001) was applied.

RESULTS

In gaseous induction group, the number of children who scored severe and very severe distress was greater than those who were in I.V. group. Gaseous induction was used for 23 children. Preoperatively, 56.5% children were in very severe distress, 17.4% in severe distress, 13% in moderate distress, 8.7% in mild distress and only one (4.3%) showed no distress. For I.V. induction, 11.2% children were in very severe distress, 9% in severe distress, and 9.6% in moderate distress, 24.2% in mild distress and 46.1% showed no distress.

CONCLUSIONS

Gaseous induction anesthesia for extractions of teeth does produce high levels of distress than I.V. induction in children for dental extractions. There was no significant difference between both induction methods in terms of distress levels at the time of recovery and 15 min postoperatively.

摘要

背景

牙科治疗中的焦虑和痛苦是牙科患者的一个主要问题,在儿童牙科患者中可能会更加严重。

目的

旨在研究全身麻醉的不同诱导方法如何影响儿童在拔牙等牙科手术中的痛苦程度。

对象与方法

这是一项在曼彻斯特大学牙科医院进行的观察性临床研究。儿童通过静脉注射(I.V.)或气体诱导进行麻醉诱导。在不同时间间隔为儿童完成改良儿童笑脸量表。

所用统计分析方法

应用独立t检验的P值,静脉注射组和吸入组的平均痛苦评分之间存在统计学显著差异(P < 0.001)。

结果

在气体诱导组中,痛苦程度评分为重度和极重度的儿童数量多于静脉注射组。23名儿童采用气体诱导。术前,56.5%的儿童处于极重度痛苦,17.4%处于重度痛苦,13%处于中度痛苦,8.7%处于轻度痛苦,只有一名(4.3%)无痛苦。对于静脉注射诱导,11.2%的儿童处于极重度痛苦,9%处于重度痛苦,9.6%处于中度痛苦,24.2%处于轻度痛苦,46.1%无痛苦。

结论

在儿童拔牙时,气体诱导麻醉比静脉注射诱导产生的痛苦程度更高。两种诱导方法在恢复时和术后15分钟的痛苦程度方面没有显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd8e/4279347/a4fa4b466bd6/SJA-9-33-g001.jpg

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