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音乐对儿科牙科治疗中镇静深度和镇静药物使用的影响。

Effects of music on sedation depth and sedative use during pediatric dental procedures.

机构信息

Department of Anesthesiology, Baskent University, Fevzi Cakmak Cad. 10. Sok. No: 45 06490 Bahcelievler, Ankara, Turkey.

Department of Anesthesiology, Baskent University, Fevzi Cakmak Cad. 10. Sok. No: 45 06490 Bahcelievler, Ankara, Turkey.

出版信息

J Clin Anesth. 2016 Nov;34:647-53. doi: 10.1016/j.jclinane.2016.07.001. Epub 2016 Aug 3.

Abstract

STUDY OBJECTIVE

The study aimed to investigate the effects of listening to music or providing sound isolation on the depth of sedation and need for sedatives in pediatric dental patients.

DESIGN

Prospective, randomized, and controlled study.

SETTING

Tertiary, university hospital.

PATIENTS

In total, 180 pediatric patients, American Society of Anesthesiologists physical status I and II, who were scheduled for dental procedures of tooth extraction, filling, amputation, and root treatment.

INTERVENTIONS

Patients were categorized into 3 groups: music, isolation, and control. During the procedures, the patients in the music group listened to Vivaldi's The Four Seasons violin concertos by sound-isolating headphones, whereas the patients in the isolation group wore the headphones but did not listen to music. All patients were sedated by 0.1 mg/kg midazolam and 1 mg/kg propofol. During the procedure, an additional 0.5 mg/kg propofol was administered as required.

MEASUREMENTS AND MAIN RESULTS

Bispectral index was used for quantifying the depth of sedation, and total dosage of the propofol was used for sedative requirements. The patients' heart rates, oxygen saturations, and Observer's Assessment of Alertness and Sedation Scale and bispectral index scores, which were monitored during the operation, were similar among the groups. In terms of the amount of propofol used, the groups were similar. Prolonged postoperative recovery cases were found to be significantly frequent in the control group, according to the recovery duration measurements (P = .004).

CONCLUSIONS

Listening to music or providing sound isolation during pediatric dental interventions did not alter the sedation level, amount of medication, and hemodynamic variables significantly. This result might be due to the deep sedation levels reached during the procedures. However, listening to music and providing sound isolation might have contributed in shortening the postoperative recovery duration of the patients.

摘要

研究目的

本研究旨在探讨在儿科牙科患者中,听音乐或提供隔音对镇静深度和镇静药物需求的影响。

设计

前瞻性、随机对照研究。

设置

三级、大学医院。

患者

总共 180 名儿科患者,美国麻醉医师协会身体状况 I 和 II,计划进行拔牙、补牙、截肢和根管治疗的牙科手术。

干预措施

患者分为 3 组:音乐组、隔离组和对照组。在手术过程中,音乐组的患者通过隔音耳机聆听维瓦尔第的《四季》小提琴协奏曲,而隔离组的患者则戴着耳机但不聆听音乐。所有患者均接受 0.1mg/kg 咪达唑仑和 1mg/kg 异丙酚镇静。手术过程中,根据需要额外给予 0.5mg/kg 异丙酚。

测量和主要结果

使用双频谱指数来量化镇静深度,使用异丙酚的总剂量来衡量镇静药物的需求。在手术过程中监测患者的心率、血氧饱和度、警觉和镇静观察量表评分和双频谱指数评分,结果显示各组之间相似。在异丙酚使用量方面,各组之间没有差异。根据恢复时间测量,发现对照组中术后恢复时间延长的病例明显增多(P =.004)。

结论

在儿科牙科干预期间听音乐或提供隔音并没有显著改变镇静水平、药物用量和血液动力学变量。这一结果可能是由于手术过程中达到了深度镇静。然而,听音乐和提供隔音可能有助于缩短患者的术后恢复时间。

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