Maeda Shigeru, Honda Yuka, Tanimura Hiroshi, Tomoyasu Yumiko, Higuchi Hitoshi, Murata Naomichi, Egusa Masahiko, Miyawaki Takuya
Department of Dental Anesthesiology, Okayama University Hospital, Okayama, Japan.
Department of Dental Anesthesiology and Special Care Dentistry, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Open Dent J. 2017 Mar 31;11:181-186. doi: 10.2174/1874210601711010181. eCollection 2017.
The extraction of lower wisdom teeth is often performed under general anesthesia in patients with intellectual disabilities. However, the choice of analgesics has not yet been investigated.
To analyze the use of analgesics during general anesthesia for extraction including lower wisdom teeth in patients with intellectual disabilities.
This research is a retrospective observational study. The study population was composed of all patients presenting for extraction of lower wisdom teeth under ambulatory general anesthesia in the clinic of Special Needs Dentistry in Okayama University Hospital from April 2011 to March 2016. The distribution of the combination of analgesics and the relationship between the use of analgesics and the type of extraction were investigated.
One hundred and twelve cases were enrolled in this study. Intravenous injections of flurbiprofen, acetaminophen and betamethasone were used in 96 (85.7%), 12 (10.7%) and 26 cases (23.2%), respectively. Flurbiprofen is a non-steroid anti-inflammatory drugs (NSAIDs). Acetaminophen is an old analgesic, but an injection of acetaminophen is new, which was released in 2013 in Japan. And betamethasone is not an analgesic, but a steroid. Betamethasone was used in combination with other analgesics, and was used at a higher dose in a case in which four wisdom teeth were extracted.
Flurbiprofen was the main analgesic used for extraction of wisdom teeth under general anesthesia in patients with intellectual disabilities. Betamethasone was used to support flurbiprofen or acetaminophen for extractions of multiple wisdom teeth, with the aim of controlling swelling rather than relieving pain.
在智障患者中，下颌智齿拔除术通常在全身麻醉下进行。然而，镇痛药的选择尚未得到研究。
分析智障患者在全身麻醉下拔除包括下颌智齿在内的牙齿时镇痛药的使用情况。
本研究为回顾性观察研究。研究对象为2011年4月至2016年3月在冈山大学医院特殊需求牙科诊所接受门诊全身麻醉下拔除下颌智齿的所有患者。调查了镇痛药组合的分布情况以及镇痛药使用与拔牙类型之间的关系。
本研究共纳入112例病例。分别有96例（85.7%）、12例（10.7%）和26例（23.2%）静脉注射氟比洛芬、对乙酰氨基酚和倍他米松。氟比洛芬是一种非甾体抗炎药（NSAIDs）。对乙酰氨基酚是一种老的镇痛药，但对乙酰氨基酚注射液是新的，于2013年在日本上市。倍他米松不是镇痛药，而是一种类固醇。倍他米松与其他镇痛药联合使用，在拔除四颗智齿的病例中使用剂量较高。
氟比洛芬是智障患者全身麻醉下拔除智齿的主要镇痛药。倍他米松用于辅助氟比洛芬或对乙酰氨基酚进行多颗智齿拔除，目的是控制肿胀而非缓解疼痛。
