Razavi Seyed Sajad, Malekianzadeh Bita
School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Anesthesiol Res Pract. 2022 Jun 22;2022:5259283. doi: 10.1155/2022/5259283. eCollection 2022.
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.
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.
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%.
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.
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。
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。
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%。
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。