Viana Karolline A, Moterane Mônica M, Green Steven M, Mason Keira P, Costa Luciane R
Dentistry Graduate Program, Faculdade de Odontologia, Universidade Federal de Goiás, Goiânia 74000-000, Goiás, Brazil.
Department of Emergency Medicine, Loma Linda University, Loma Linda, CA 92354, USA.
J Clin Med. 2021 Nov 20;10(22):5430. doi: 10.3390/jcm10225430.
The incidence of peri-procedural amnesia following procedural sedation in children is unclear and difficult to determine. This study aimed to apply quantitative and qualitative approaches to better understand amnesia following dental sedation of children. After Institutional Review Board Approval, children scheduled for sedation for dental procedures with oral midazolam (OM), oral midazolam and ketamine (OMK), or intranasal midazolam and ketamine (IMK) were recruited for examination of peri-procedural amnesia. Amnesia during the dental session was assessed using a three-stage method, using identification of pictures and an animal toy. On the day following the sedation, primary caregivers answered two questions about their children's memory. One week later, the children received a semi-structured interview. Behavior and level of sedation during the dental session were recorded. Quantitative data were analyzed using descriptive statistics and comparison tests. Qualitative data were analyzed using content analysis. Triangulation was used. Thirty-five children (age: 36 to 76 months) participated in the quantitative analysis. Most children showed amnesia for the dental procedure (82.9%, = 29/35) and remembered receiving the sedation (82.1%, = 23/28 for oral administration; 59.3%, = 16/27 for intranasal administration). The occurrence of amnesia for the dental procedure was slightly higher in the oral midazolam group compared with the other groups (44.8%, = 13/29 for OM, 13.8%, = 4/29 for OMK, and 41.4%, = 12/29 for IMK). Twenty-eight children participated in the qualitative approach. The major theme identified was that some children could remember their procedures in detail. We conclude that peri-procedural amnesia of the dental procedure was common following sedation.
儿童在程序性镇静后发生围手术期遗忘的发生率尚不清楚且难以确定。本研究旨在采用定量和定性方法，以更好地了解儿童牙科镇静后的遗忘情况。经机构审查委员会批准后，招募计划接受口服咪达唑仑（OM）、口服咪达唑仑和氯胺酮（OMK）或鼻内咪达唑仑和氯胺酮（IMK）进行牙科手术镇静的儿童，以检查围手术期遗忘情况。使用识别图片和动物玩具的三阶段方法评估牙科治疗期间的遗忘情况。在镇静后的第二天，主要照顾者回答两个关于其孩子记忆的问题。一周后，对儿童进行半结构化访谈。记录牙科治疗期间的行为和镇静水平。定量数据采用描述性统计和比较检验进行分析。定性数据采用内容分析法进行分析。采用了三角互证法。35名儿童（年龄：36至76个月）参与了定量分析。大多数儿童对牙科手术存在遗忘（82.9%，n = 29/35），且记得接受了镇静（口服给药的为82.1%，n = 23/28；鼻内给药的为59.3%，n = 16/27）。与其他组相比，口服咪达唑仑组牙科手术遗忘的发生率略高（OM组为44.8%，n = 13/29；OMK组为13.8%，n = 4/29；IMK组为41.4%，n = 12/29）。28名儿童参与了定性研究。确定的主要主题是一些儿童能够详细记住他们的治疗过程。我们得出结论，牙科手术的围手术期遗忘在镇静后很常见。
