Doshi Mili, Kahatab Ahmed, Gallagher Louise, Prasad Ria, Fitzgerald Richard
Consultant in Special Care Dentistry, Royal Hospital for Neuro-disability, London, UK.
Specialist Registrar in Special Care Dentistry, Surrey and Sussex NHS Health Care Trust, Redhill, UK.
BDJ Open. 2024 Dec 30;10(1):101. doi: 10.1038/s41405-024-00289-2.
Dental treatment may not be possible for patients with a profound acquired brain injury without pharmacological support. Intravenous (IV) sedation with midazolam is a widely accepted, safe, and effective mode of treatment for people with a disability, but there is limited evidence in this patient cohort.
This evaluation aimed to review the IV sedation service for patients with profound acquired brain injury within the dental department at the Royal Hospital for Neuro-disability.
This study was a retrospective service evaluation of IV sedation for dental treatment over seven years. Descriptive statistics are presented.
In total, 303 episodes of sedation were undertaken at the Royal Hospital of Neurodisability over seven years. Ninety-two percent were graded with an American Society of Anaesthesiologists (ASA) grade 3, and one-third had a history of stroke. 91% had treatment completed successfully. Complications occurred in 7.9% of cases, but all were minor, with no resulting patient harm (e.g. a transient drop in oxygen saturation).
Dentist-led IV sedation with midazolam is safe and effective for dental treatment for patients with a profound acquired brain injury in a specialised setting with experienced clinicians.
对于患有严重后天性脑损伤且没有药物支持的患者，可能无法进行牙科治疗。使用咪达唑仑进行静脉镇静是一种被广泛接受、安全且有效的残疾患者治疗方式，但在这一患者群体中的证据有限。
本评估旨在回顾皇家神经残疾医院牙科部门为患有严重后天性脑损伤的患者提供的静脉镇静服务。
本研究是对七年期间牙科治疗静脉镇静的回顾性服务评估。呈现描述性统计数据。
在七年时间里，皇家神经残疾医院共进行了303次镇静治疗。92%的患者美国麻醉医师协会（ASA）分级为3级，三分之一有中风病史。91%的治疗成功完成。7.9%的病例出现并发症，但均为轻微并发症，未对患者造成伤害（例如血氧饱和度短暂下降）。
在有经验的临床医生的专业环境中，由牙医主导使用咪达唑仑进行静脉镇静对患有严重后天性脑损伤的患者进行牙科治疗是安全有效的。
