Independent Researcher, Milano, Italy.
Paediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy.
F1000Res. 2019 Nov 1;8:1843. doi: 10.12688/f1000research.20712.2. eCollection 2019.
Anxiety and distress can jeopardize dental care experience of patients and may affect the clinical result. Although a wide range of sedation and analgesia techniques are currently available to relieve distress and pain during dental procedures, operative models to choose the most effective sedation-analgesic strategies are still insufficient. This case series proposes a patient-centered model to optimize patients' cooperation during dental care delivery. We describe how to achieve correct anaesthesia by using the least sedative procedure, accounting for the dental procedure needed and patient's psychological profile. Five patients were considered as paradigmatic to show the balance between patients' subjective experiences and the clinical procedures: a patient with low stress, good compliance (case 1); a patient with moderate stress and reduction in compliance (case 2); anxious patient (case 3); a patient with acute anxiety and emotional distress (case 4); anguished patient (case 5). A multimodal treatment of emotional and behavioural condition and a patient-centered model approach contributed to achieve the best patient satisfaction in the five cases detailed here.
焦虑和痛苦会危及患者的口腔护理体验，并可能影响临床效果。尽管目前有广泛的镇静和镇痛技术可用于减轻牙科手术过程中的痛苦和疼痛，但选择最有效的镇静镇痛策略的手术模型仍然不足。本病例系列提出了一种以患者为中心的模型，以优化患者在口腔护理过程中的合作。我们描述了如何通过使用最少的镇静程序来实现正确的麻醉，同时考虑到所需的牙科程序和患者的心理特征。选择了五名患者作为范例，以展示患者的主观体验与临床程序之间的平衡：一名压力低、配合好的患者（病例 1）；一名压力中等且配合度降低的患者（病例 2）；焦虑的患者（病例 3）；一名急性焦虑和情绪困扰的患者（病例 4）；痛苦的患者（病例 5）。情绪和行为状况的多模式治疗以及以患者为中心的治疗方法有助于在这五个详细描述的病例中实现最佳的患者满意度。
