Ahmed Sheikh Sohail, Hicks Shawn R, Slaven James E, Nitu Mara E
J Clin Pediatr Dent. 2016;40(2):156-60. doi: 10.17796/1053-4628-40.2.156.
Sedation may be needed for safe, effective completion of pediatric dental procedures. Procedural sedation is performed in a children's hospital based dental office. The three sedation approaches: a propofol-only (P-O) approach (2-3 mg/kg titrated to the needed level of sedation), an approach that includes either i.v. ketamine (K+P) (0.25 or 0.5 mg/kg) or i.v. fentanyl (F+P) (0.5-1 mcg/kg) prior to propofol administration. We sought to determine safety and efficacy of various propofol based sedation protocols.
Retrospective review of 222 patients receiving a propofol-only (P-O), ketamine+propofol (K+P) or fentanyl+propofol (F+P) approach.
There were 44 patients in P-O group, 154 in K+P group and 24 in F+P group with mean age (4.8±3.4 y) and mean weight (19.7±6.7 kg). All the patients completed procedures successfully. Mild hypoxemia occurred in 24% of cases and resolved with nasal cannula. Mean total dose of propofol was similar in all groups (P-O 8.2 mg/kg, K+P 9.5 mg/kg, F+P 9.6 mg/kg, p=0.15). Although procedure and recovery times were similar in all groups, discharge times in K+P group were significantly shorter than P-O group and F+P group respectively (K+P 9.35±8.93.min, P-O 13.57±10.42 min, F+P 10.42±4.40 p= 0.002).
Sedation can be accomplished safely and effectively in a children's hospital based dental office using propofol-based sedation.
为安全、有效地完成儿童牙科手术，可能需要进行镇静。程序镇静在儿童医院的牙科诊所进行。三种镇静方法：仅使用丙泊酚（P - O）的方法（2 - 3毫克/千克，根据所需镇静水平滴定），一种在给予丙泊酚之前包括静脉注射氯胺酮（K + P）（0.25或0.5毫克/千克）或静脉注射芬太尼（F + P）（0.5 - 1微克/千克）的方法。我们试图确定各种基于丙泊酚的镇静方案的安全性和有效性。
对222例接受仅丙泊酚（P - O）、氯胺酮+丙泊酚（K + P）或芬太尼+丙泊酚（F + P）方法的患者进行回顾性研究。
P - O组有44例患者，K + P组有154例，F + P组有24例，平均年龄（4.8±3.4岁），平均体重（19.7±6.7千克）。所有患者均成功完成手术。24%的病例出现轻度低氧血症，通过鼻导管吸氧得到缓解。所有组丙泊酚的平均总剂量相似（P - O组8.2毫克/千克，K + P组9.5毫克/千克，F + P组9.6毫克/千克，p = 0.15）。虽然所有组的手术和恢复时间相似，但K + P组的出院时间分别显著短于P - O组和F + P组（K + P组9.35±8.93分钟，P - O组13.57±10.42分钟，F + P组10.42±4.40分钟，p = 0.002）。
在儿童医院的牙科诊所使用基于丙泊酚的镇静可以安全有效地实现镇静。
