Murakami Kazuhiro, Horita Satoshi, Tsuyuki Motokatsu, Moriyasu Akihito
Department of Oral and Maxillofacial Surgery, Nara Medical University, 840, Shijo-Cho, 634-8522, Kashihara, Nara, Japan.
Department of Internal Medicine, Hattori Memorial Hospital, 4244 Kanmaki, 639-0214, Kamimaki-cho, Kitakatsuragi-gun, Nara, Japan.
Oral Maxillofac Surg. 2025 Jan 14;29(1):31. doi: 10.1007/s10006-024-01326-y.
This study aimed to analyze changes in anxiety and comfort levels at each perioperative stage during third molar extraction under single-agent intravenous midazolam sedation, and to clarify how these conditions at each perioperative stage affect postoperative satisfaction.
115 who requested extraction of 1 ~ 4 third molars under single-agent intravenous midazolam sedation were targeted. These patients were administered a questionnaire survey one week after surgery. The questionnaire's five items (Anxiety before surgery, Comfort during surgery, Comfort after surgery, Amnesia, and Satisfaction) were evaluated using a visual analog scale (VAS). We investigated the correlation between each of the eight parameters which added age, operation time, and total amount of midazolam, to the VAS score. Furthermore, we compared each eight parameters according to the number of extracted wisdom teeth and sex differences.
Regarding the correlation among each parameter, low preoperative anxiety were weak and positively correlated with reduced operation time reduced midazolam dosage, and an increase in postoperative comfort. All parameters influenced the patient's satisfaction level. Those levels were significantly affected by preoperative reassurance (r = 0.4402, p < 0.01), postoperative comfort (r = 0.5522, p < 0.01) amnesia (r = 0.5741, p < 0.01), and intraoperative comfort (r = 0.7578, p < 0.01). Each parameter had no significant difference depending on the number of teeth extracted. In comparison between men and women, only preoperative reassurance was significantly lower in women than in men (p<0.05).
This sedation effectively managed preoperative anxiety and improved postoperative satisfaction. To obtain good sedative condition, Preoperative anxiolytics are recommended. This sedation is considered particularly effective in women.
本研究旨在分析单剂静脉注射咪达唑仑镇静下拔除第三磨牙围手术期各阶段焦虑和舒适度的变化，并阐明围手术期各阶段的这些状况如何影响术后满意度。
以115例在单剂静脉注射咪达唑仑镇静下要求拔除1至4颗第三磨牙的患者为研究对象。这些患者在术后一周接受问卷调查。问卷的五个项目（术前焦虑、术中舒适度、术后舒适度、遗忘症和满意度）采用视觉模拟量表（VAS）进行评估。我们研究了在VAS评分基础上增加年龄、手术时间和咪达唑仑总量后的八个参数之间的相关性。此外，我们根据拔除智齿的数量和性别差异比较了这八个参数。
关于各参数之间的相关性，术前焦虑程度低与手术时间缩短、咪达唑仑剂量减少以及术后舒适度提高呈弱正相关。所有参数均影响患者的满意度水平。这些水平受到术前安慰（r = 0.4402，p < 0.01）、术后舒适度（r = 0.5522，p < 0.01）、遗忘症（r = 0.5741，p < 0.01）和术中舒适度（r = 0.7578，p < 0.01）的显著影响。各参数在拔牙数量方面无显著差异。在男性和女性的比较中，仅术前安慰女性显著低于男性（p < 0.05）。
这种镇静有效地控制了术前焦虑并提高了术后满意度。为获得良好的镇静状态，建议使用术前抗焦虑药。这种镇静在女性中被认为特别有效。
