Sharma Mridul, Sahu Amit K, Kaila Puja, Hassan Ali Abdel H A A, Mansy Mohamed, Thakur Raksha, Homeida Husham E
Department of Smart Healthcare, Indian Institute of Technology and All Indian Institute of Medical Sciences, Jodhpur, Rajasthan, India.
Assistant Professor, Government Medical College, Sheopur, Madhya Pradesh, India.
J Pharm Bioallied Sci. 2024 Dec;16(Suppl 4):S3150-S3152. doi: 10.4103/jpbs.jpbs_637_24. Epub 2024 Nov 29.
Dental procedures often require local anesthesia, but managing fearful patients, especially children, can be challenging, potentially leading to dental phobia development. Sedation methods such as conscious sedation, deep sedation, or general anesthesia can aid in managing these patients.
This study focuses on evaluating various sedation techniques used in an Oral and Maxillofacial Surgery Clinic for adults with special needs requiring dental treatments under sedation or general anesthesia. A retrospective analysis was conducted on 250 adult patients with special needs who underwent dental procedures between January 2019 and December 2023. Data on demographic characteristics, types of procedures, sedation techniques used, dosages, and complications were collected from medical records. Sedation techniques included midazolam-sufentanil, ketamine-midazolam, oral midazolam, chloral hydrate, ketamine, and propofol.
The midazolam-sufentanil combination was the most commonly used sedation technique (27.2%), followed by ketamine-midazolam (21.6%). Complications such as respiratory issues (2.9%), cardiovascular events (1.5%), nausea/vomiting (4.4%), and prolonged recovery time (2.9%) were observed.
Overall, the incidence of complications was relatively low, indicating the safety and efficacy of the sedation techniques. Sedation techniques, particularly the midazolam-sufentanil and ketamine-midazolam combinations, were found to be effective and safe for managing dental procedures in adults with special needs. Personalized sedation approaches based on individual patient factors are essential for optimizing outcomes. Further research is needed to explore long-term effects and patient satisfaction.
牙科手术通常需要局部麻醉，但管理恐惧的患者，尤其是儿童，可能具有挑战性，有可能导致牙科恐惧症的形成。诸如清醒镇静、深度镇静或全身麻醉等镇静方法有助于管理这些患者。
本研究重点评估口腔颌面外科诊所用于有特殊需求的成人的各种镇静技术，这些成人在镇静或全身麻醉下需要进行牙科治疗。对2019年1月至2023年12月期间接受牙科手术的250名有特殊需求的成年患者进行了回顾性分析。从病历中收集了人口统计学特征、手术类型、使用的镇静技术、剂量和并发症等数据。镇静技术包括咪达唑仑-舒芬太尼、氯胺酮-咪达唑仑、口服咪达唑仑、水合氯醛、氯胺酮和丙泊酚。
咪达唑仑-舒芬太尼联合用药是最常用的镇静技术（27.2%），其次是氯胺酮-咪达唑仑（21.6%）。观察到诸如呼吸问题（2.9%）、心血管事件（1.5%）、恶心/呕吐（4.4%）和恢复时间延长（2.9%）等并发症。
总体而言，并发症发生率相对较低，表明镇静技术的安全性和有效性。镇静技术，特别是咪达唑仑-舒芬太尼和氯胺酮-咪达唑仑联合用药，被发现对管理有特殊需求的成人的牙科手术有效且安全。基于个体患者因素的个性化镇静方法对于优化结果至关重要。需要进一步研究以探索长期影响和患者满意度。
