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成人经口给予咪达唑仑镇静在牙科中的应用——一项回顾性研究。

Sedation of Adults with Orally Administered Midazolam in Dentistry - A Retrospective Study.

机构信息

Department of Plastic & Oral and Maxillofacial Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.

Department of Plastic & Oral and Maxillofacial Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; Department of Orofacial Medicine, Public Dental Health, Region Uppsala, Sweden.

出版信息

Acta Odontol Scand. 2024 Sep 19;83:507-515. doi: 10.2340/aos.v83.41403.

Abstract

OBJECTIVE

The use of midazolam (MZ) has increased in dentistry, but the effect in adults is sparsely studied. The aim of this study was to investigate doses, effects, and side effects of orally administered MZ as a sedative for adults in a dental care organization.

MATERIAL AND METHODS

A retrospective record review was performed including all adult patients in the dental care organization ≥20 years receiving MZ, identified through a logbook for addictive drugs, during 2020. From patients' records, the following data were extracted: age, gender, medical history, reason for sedation, performed treatments, doses, effects, and side effects of MZ.  Results: In total, 265 patients on 418 occasions had been sedated, which constituted 2.3 sedations per 1,000 visits and 3.3 sedations per 1,000 treated patients. Mean age was 40.8 years and 67.7% were females. The most common reason for sedation was anxiety. Mean dose in primary dental clinics was 7.9 mg and in specialist clinics, 6.8 mg (p < 0.001). Older patients (>70 years) had lower doses than younger (p < 0.001), while no difference was found between ages 55-70 years and those who were younger. Dental treatment was completed in 91.9% of occasions, and side effects were registered in 2.2%. Successful dental treatment was related to type of treatment performed.

CONCLUSIONS

Sedation is rarely used, particularly in primary dental care, and the use varies widely between clinics. MZ administered by dentists seems to be safe and effective. A sedation record should be used to make patient data such as weight and medical conditions available.

摘要

目的

咪达唑仑(MZ)在牙科中的应用有所增加,但成年人的相关效果研究较少。本研究旨在调查口腔给予 MZ 作为牙科保健机构中成年人镇静剂的剂量、效果和副作用。

材料和方法

通过成瘾药物日志对 2020 年期间在牙科保健机构中接受 MZ 的所有≥20 岁的成年患者进行了回顾性病历回顾。从患者记录中提取以下数据:年龄、性别、病史、镇静原因、进行的治疗、MZ 的剂量、效果和副作用。

结果

共有 265 名患者在 418 次就诊时接受了镇静治疗,每 1000 次就诊中有 2.3 次镇静治疗,每 1000 名治疗患者中有 3.3 次镇静治疗。平均年龄为 40.8 岁,女性占 67.7%。镇静的最常见原因是焦虑。初级牙科诊所的平均剂量为 7.9mg,专科诊所为 6.8mg(p<0.001)。年龄较大的患者(>70 岁)的剂量低于年龄较小的患者(p<0.001),而 55-70 岁和年龄较小的患者之间没有差异。91.9%的就诊时完成了牙科治疗,2.2%记录了副作用。成功的牙科治疗与所进行的治疗类型有关。

结论

镇静治疗很少使用,特别是在初级牙科保健中,而且诊所之间的使用差异很大。牙医给予的 MZ 似乎是安全有效的。应使用镇静记录来提供患者数据,如体重和身体状况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cde/11425061/183c223f4204/AOS-83-41403-g001.jpg

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