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Conscious sedation in children: the need to strengthen the evidence base remains.儿童清醒镇静:加强证据基础的必要性依然存在。
Evid Based Dent. 2019 Jun;20(2):62-63. doi: 10.1038/s41432-019-0032-7.
2
Practice Guidelines for Moderate Procedural Sedation and Analgesia 2018: A Report by the American Society of Anesthesiologists Task Force on Moderate Procedural Sedation and Analgesia, the American Association of Oral and Maxillofacial Surgeons, American College of Radiology, American Dental Association, American Society of Dentist Anesthesiologists, and Society of Interventional Radiology.《2018年适度程序性镇静与镇痛实践指南:美国麻醉医师协会适度程序性镇静与镇痛特别工作组、美国口腔颌面外科医师协会、美国放射学会、美国牙科协会、美国牙科麻醉医师协会及介入放射学会报告》
Anesthesiology. 2018 Mar;128(3):437-479. doi: 10.1097/ALN.0000000000002043.
3
Ethics Rounds: Death After Pediatric Dental Anesthesia: An Avoidable Tragedy?伦理查房:小儿牙科麻醉后的死亡:一场可避免的悲剧?
Pediatrics. 2017 Dec;140(6). doi: 10.1542/peds.2017-2370. Epub 2017 Nov 7.
4
Conscious Sedation: Emerging Trends in Pediatric Dentistry.清醒镇静:儿科牙科的新趋势
Anesth Essays Res. 2017 Apr-Jun;11(2):277-281. doi: 10.4103/0259-1162.171458.
5
Post-Discharge Events Occurring after Dental Treatment under Deep Sedation in Pediatric Patients.儿科患者在深度镇静下进行牙科治疗后发生的出院后事件。
J Clin Pediatr Dent. 2017;41(3):232-235. doi: 10.17796/1053-4628-41.3.232.
6
Deep Sedation for Pediatric Dental Procedures: Is this a Safe and Effective Option?小儿牙科手术的深度镇静:这是一个安全有效的选择吗?
J Clin Pediatr Dent. 2016;40(2):156-60. doi: 10.17796/1053-4628-40.2.156.
7
Pediatric dental sedation: challenges and opportunities.儿童牙科镇静:挑战与机遇
Clin Cosmet Investig Dent. 2015 Aug 26;7:97-106. doi: 10.2147/CCIDE.S64250. eCollection 2015.
8
Distraction as a technique to control pain in pediatric patients during venipuncture. A narrative review of literature.分散注意力作为儿科患者静脉穿刺时控制疼痛的一种技术。文献综述。
Prof Inferm. 2015 Jan-Mar;68(1):52-62. doi: 10.7429/pi.2015.681052.
9
A comparison of sedation-related events for two multiagent oral sedation regimens in pediatric dental patients.两种多药物口服镇静方案用于儿科牙科患者时与镇静相关事件的比较。
Pediatr Dent. 2014 Jul-Aug;36(4):302-8.
10
Safety and efficacy of propofol administered by paediatricians during procedural sedation in children.儿科医生在小儿镇静程序中使用异丙酚的安全性和疗效。
Acta Paediatr. 2014 Feb;103(2):182-7. doi: 10.1111/apa.12472. Epub 2013 Dec 3.

小儿牙科患者深度镇静的疗效与并发症:一项回顾性队列研究

The Efficacy and Complications of Deep Sedation in Pediatric Dental Patients: A Retrospective Cohort Study.

作者信息

Razavi Seyed Sajad, Malekianzadeh Bita

机构信息

School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Anesthesiol Res Pract. 2022 Jun 22;2022:5259283. doi: 10.1155/2022/5259283. eCollection 2022.

DOI:10.1155/2022/5259283
PMID:35783546
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9242812/
Abstract

BACKGROUND

Dental anxiety in children is a common problem. Currently, many of dental procedures are performed under sedation. Different methods of sedation have been employed for this purpose. Compared to adults, children usually need a deeper sedation level. The aim of this retrospective study is to assess the efficacy and complication of deep sedation in pediatric dental patients.

METHOD

This study was performed on 250 ASA (American Society of Anesthesiologists) I, II children undergoing deep sedation during the dental procedures. After the administration of oral midazolam as premedication, the monitoring process started. The patients that received the sedation dose of propofol and oxygen through nasal cannula during the procedure were carefully monitored for the purpose of evaluating hemodynamic and respiratory complications. The mean procedure and recovery time, postoperative nausea and vomiting (PONV), and success rate were further studied.

RESULT

The average age of the patients was 3.7. 32% of the patients were females, and 68% of them were males. Laryngospasm that occurred in 5 cases was resolved immediately by using positive pressure ventilation. Mild hypoxia was observed in 17 cases which were immediately managed by a bag-valve-mask ventilation. No cases of hemodynamic complications and PONV were reported. The mean length of the procedure was 57 minutes, and the mean length of recovery was 16 minutes. The success rate of this method was estimated to be 99.6%.

CONCLUSION

Deep sedation with propofol is a suitable technique with a high success rate for dental procedures in children. It was also concluded that in pediatric dental procedures, the presence of a skilled anesthetist and the implementation of a close monitoring process are required.

摘要

背景

儿童牙科焦虑是一个常见问题。目前,许多牙科手术是在镇静状态下进行的。为此采用了不同的镇静方法。与成人相比,儿童通常需要更深的镇静水平。这项回顾性研究的目的是评估小儿牙科患者深度镇静的疗效和并发症。

方法

本研究对250例美国麻醉医师协会(ASA)分级为I、II级的儿童在牙科手术期间进行深度镇静。在给予口服咪达唑仑作为术前用药后,开始监测过程。在手术过程中通过鼻导管接受丙泊酚镇静剂量和氧气的患者,为评估血流动力学和呼吸并发症而进行仔细监测。进一步研究平均手术和恢复时间、术后恶心呕吐(PONV)及成功率。

结果

患者的平均年龄为3.7岁。32%的患者为女性,68%为男性。5例发生的喉痉挛通过正压通气立即得到缓解。17例观察到轻度低氧血症,通过面罩球囊通气立即得到处理。未报告血流动力学并发症和PONV病例。平均手术时长为57分钟,平均恢复时长为16分钟。该方法的成功率估计为99.6%。

结论

丙泊酚深度镇静是一种适用于儿童牙科手术且成功率高的技术。还得出结论,在小儿牙科手术中,需要有熟练的麻醉师在场并实施密切监测过程。