Lee Soo Jeong, Baek Kwangwoo
Division of Pediatric Dentistry, Department of Dentistry, Ajou University School of Medicine, Suwon, Korea.
J Dent Anesth Pain Med. 2015 Dec;15(4):213-220. doi: 10.17245/jdapm.2015.15.4.213. Epub 2015 Dec 31.
Pediatric dentists face challenges when young patients require a mesiodens extraction. General anesthesia may be a burden to the child as well as the parent due to dental fears and costs. The aim of this study was to evaluate oral and intravenous sedation in the outpatient setting as a safe and effective means of managing patients who require a mesiodens extraction.
Records were reviewed retrospectively to find patients who underwent a mesiodens removal procedure from January 2013 to September 2014 in the Department of Pediatric Dentistry at Ajou University Hospital (Suwon, Gyeonggi-do, Republic of Korea). A total of 81 patients (62 male and 19 female) between 4 and 11 years of age (mean [± SD] 81.6 ± 14.1 months) were studied, with a mean weight of 22.9 ± 3.3 kg (16 kg to 30 kg). Vital signs, sedation drug dosage, and sedation time were studied.
Mean doses of 63.7 ± 2.5 mg/kg chloral hydrate and 1.36 ± 0.22 mg/kg hydroxyzine were used for oral sedation. Nitrous oxide/oxygen was administrated for 40.0 ± 2.1 min. The mean dose of midazolam administered intravenously was 0.14 ± 0.06 mg/kg (2.38 ± 0.97 times). In all cases, the mesiodens was removed successfully.
Intravenous sedation combined with oral sedation and nitrous oxide/oxygen inhalation can be an alternative to general anesthesia when administrated and monitored properly.
当年轻患者需要拔除多生牙时，儿童牙医面临挑战。由于牙科恐惧和费用问题，全身麻醉可能对儿童及其家长都是一种负担。本研究的目的是评估门诊环境下的口服和静脉镇静作为管理需要拔除多生牙患者的一种安全有效的方法。
回顾性查阅记录，以找出2013年1月至2014年9月在韩国京畿道水原市阿朱大学医院儿科牙科接受多生牙拔除手术的患者。共研究了81例年龄在4至11岁（平均[±标准差]81.6±14.1个月）的患者，平均体重为22.9±3.3千克（16千克至30千克）。研究了生命体征、镇静药物剂量和镇静时间。
口服镇静使用的水合氯醛平均剂量为63.7±2.5毫克/千克，羟嗪平均剂量为1.36±0.22毫克/千克。一氧化二氮/氧气给药40.0±2.1分钟。静脉注射咪达唑仑的平均剂量为0.14±0.06毫克/千克（2.38±0.97倍）。在所有病例中，多生牙均成功拔除。
当正确给药和监测时，静脉镇静联合口服镇静和一氧化二氮/氧气吸入可作为全身麻醉的替代方法。
