Pérez-García Silvia, Ruiz-Roca Juan-Antonio, Añez Cristobal, López-Jornet Pía, Gargallo-Albiol Jordi
DDS, MS. Assistant Professor. Department of Oral and Maxillofacial Surgery. Universitat Internacional de Catalunya, Sant Cugat del Vallés (Barcelona), Spain.
DDS, MS, PhD. Assistant Professor. Department of Stomatology. Faculty of Dentistry. University of Murcia, Murcia, Spain.
J Clin Exp Dent. 2022 Nov 1;14(11):e911-e919. doi: 10.4317/jced.59951. eCollection 2022 Nov.
Very limited data are available on the hemodynamic and ventilatory changes during sedation and general anesthesia using bispectral index (BIS) monitoring in intellectually disabled children. The purpose was to determine the hemodynamic and ventilatory changes after propofol and sevoflurane administration in children with special needs (CSN) versus healthy children (HC) during dental treatment.
Forty pediatric patients needing dental treatment were allocated into two groups: children without systemic disease (healthy children [HC]) and mentally disabled children (children with special needs [CSN]). Sevoflurane in oxygen (100% oxygen, 5 l/min) and continuous propofol infusion (target-controlled infusion [TCI], 2 µg/ml) were used as sedative agents, and 2% lidocaine with 1:80,000 adrenaline was used as local anesthesia in both groups. Heart rate (HR), oxygen saturation (SaO2), respiratory rate (RR), exhaled carbon dioxide (CO2), blood pressure (BP) and bispectral monitoring (BIS) values were recorded during the entire dental treatment procedure.
A statistically significant decrease in systolic BP, diastolic BP and RR was observed, with no significant differences between the healthy and disabled groups. In contrast, the HR and BIS values were lower in the CSN group than in the healthy patients ( ≤ 0.05).
Patients with special needs had lower HR and BIS values than healthy patients, while BP, SaO2 and exhaled CO2 showed similar results in both groups. Bispectral index, hemodynamic changes, ventilatory changes, pediatric patients, special needs.
关于在智力残疾儿童中使用脑电双频指数（BIS）监测进行镇静和全身麻醉期间的血流动力学和通气变化的数据非常有限。目的是确定在牙科治疗期间，特殊需求儿童（CSN）与健康儿童（HC）在使用丙泊酚和七氟醚后血流动力学和通气的变化。
40名需要牙科治疗的儿科患者被分为两组：无全身性疾病的儿童（健康儿童[HC]）和智力残疾儿童（特殊需求儿童[CSN]）。两组均使用氧气中的七氟醚（100%氧气，5升/分钟）和丙泊酚持续输注（靶控输注[TCI]，2微克/毫升）作为镇静剂，以及2%利多卡因加1:80,000肾上腺素作为局部麻醉剂。在整个牙科治疗过程中记录心率（HR）、血氧饱和度（SaO2）、呼吸频率（RR）、呼出二氧化碳（CO2）、血压（BP）和脑电双频监测（BIS）值。
观察到收缩压、舒张压和RR有统计学意义的下降，健康组和残疾组之间无显著差异。相比之下，CSN组的HR和BIS值低于健康患者（≤0.05）。
特殊需求患者的HR和BIS值低于健康患者，而两组的BP、SaO2和呼出CO2结果相似。脑电双频指数、血流动力学变化、通气变化、儿科患者、特殊需求。
