Wu Xiaoran, Liu Yun, Li Binghua, Zhou Dan, Cheng Tong, Ma Tianyu, Yang Xudong, Xia Bin
Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China.
Department of Anesthesiology, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China.
J Dent Sci. 2023 Jul;18(3):1073-1078. doi: 10.1016/j.jds.2022.11.013. Epub 2022 Nov 29.
BACKGROUND/PURPOSE: Intravenous sedation with propofol in the dental treatment offers an alternative to inhalation sedation or general anesthesia. The aim of this study was to evaluate the safety and identify risk factors for intraoperative complications.
Uncooperative children who could not complete dental treatment under non-pharmacological behavior management or mild-to-moderate sedation in the outpatient pediatric department were selected. Details and time of dental treatment; intraoperative vital signs data, including blood pressure, heart rate, respiratory rate, pulse oxygen saturation (SpO), end-tidal carbon dioxide, and electrocardiogram; and incidence of intraoperative and postoperative complications were recorded.
Overall, 344 children were selected, with 342 completing dental treatment. The dental treatment time was 20-155 (median, 85; interquartile range, 70-100) min. The number of treated teeth was at least 1 and at most 13 (median, 6; interquartile range, 5-8). Among 342 children, 35 (10.2%) had their treatment interrupted temporarily due to choking cough. No serious complications occurred; the incidence rate of minor complications was 47/342 (13.7%). Tachycardia was observed in 5/342 (1.5%) cases, oxygen desaturation (SpO < 95%) in 18, and hypoxemia (SpO2 ≤ 90%) in 25. The treatment duration was significant longer in cases with than without complications ( < 0.05), and children coughing during treatment were more likely to have complications ( < 0.05). Postoperative restlessness occurred in six children, but there was no vomiting, aspiration, or respiratory obstruction.
Decreased oxygen saturation is the most common complications. Cough during treatment and longer treatment duration were risk factors for complications.
背景/目的：在牙科治疗中，丙泊酚静脉镇静为吸入镇静或全身麻醉提供了一种替代方法。本研究的目的是评估安全性并确定术中并发症的危险因素。
选取在门诊儿科无法在非药物行为管理或轻度至中度镇静下完成牙科治疗的不合作儿童。记录牙科治疗的详细情况和时间；术中生命体征数据，包括血压、心率、呼吸频率、脉搏血氧饱和度（SpO）、呼气末二氧化碳和心电图；以及术中及术后并发症的发生率。
总体而言，共选取344名儿童，其中342名完成了牙科治疗。牙科治疗时间为20 - 155（中位数85；四分位间距70 - 100）分钟。治疗牙齿数量最少1颗，最多13颗（中位数6；四分位间距5 - 8）。在342名儿童中，35名（10.2%）因呛咳导致治疗暂时中断。未发生严重并发症；轻微并发症发生率为47/342（13.7%）。5/342（1.5%）例出现心动过速，18例出现氧饱和度降低（SpO < 95%），25例出现低氧血症（SpO2≤90%）。有并发症的病例治疗持续时间显著长于无并发症的病例（< 0.05），治疗期间咳嗽的儿童更易发生并发症（< 0.05）。6名儿童术后出现躁动，但无呕吐、误吸或呼吸道梗阻。
氧饱和度降低是最常见的并发症。治疗期间咳嗽和较长的治疗持续时间是并发症的危险因素。
