Baek Kwangwoo
Department of Dentistry, Ajou University School of Medicine, Korea.
J Dent Anesth Pain Med. 2015 Jun;15(2):47-52. doi: 10.17245/jdapm.2015.15.2.47. Epub 2015 Jun 30.
Sedation allows patients to maintain their airway independently and respond appropriately to physical stimulation and verbal command while maintaining a minimum depressed level of consciousness. Drugs commonly used for sedation of pediatric dental patients include a combination of chloral hydrate, hydroxyzine, and nitrous oxide-oxygen. Midazolam is a benzodiazepine and currently one of the most commonly used intravenous sedative agents. It can be easily titrated to provide a wide range of sedation, from conscious sedation to deep sedation, and exhibits a wide safety margin without severe respiratory and circulatory depression. At an appropriate dose, it also decreases patient anxiety and induces amnesia. We found that the submucosal administration of midazolam combined with chloral hydrate provided increased sedative effects and decreased the postoperative vomiting response compared with conventional chloral hydrate administration, with no significant difference in physiological responses. The depth of sedation can be titrated using this technique.
镇静可使患者自主维持气道，并在保持最低程度意识抑制的同时，对身体刺激和言语指令做出适当反应。常用于小儿牙科患者镇静的药物包括水合氯醛、羟嗪和一氧化二氮 - 氧气的组合。咪达唑仑是一种苯二氮䓬类药物，目前是最常用的静脉镇静剂之一。它可以很容易地进行滴定，以提供从清醒镇静到深度镇静的广泛镇静范围，并且具有广泛的安全范围，不会出现严重的呼吸和循环抑制。在适当剂量下，它还可减轻患者焦虑并引起遗忘。我们发现，与传统水合氯醛给药相比，咪达唑仑联合水合氯醛黏膜下给药具有增强的镇静效果，并降低了术后呕吐反应，生理反应无显著差异。使用该技术可滴定镇静深度。
