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咪达唑仑静脉清醒镇静用于口腔外科手术。一项对372例病例的回顾性研究。

Midazolam intravenous conscious sedation in oral surgery. A retrospective study of 372 cases.

作者信息

Runes J, Ström C

机构信息

Department of Oral and Maxillofacial Surgery, County-hospital, Falun.

出版信息

Swed Dent J. 1996;20(1-2):29-33.

PMID:8738906
Abstract

In 1987 the Swedish Dental Act was amended to allow Swedish dentists who have undergone a specific accreditation course to administer intra-venous sedation. Midazolam is a benzodiazepin derivate with express sedative and hypnotic qualities, powerful amnesia, a short half-life time and few secondary effects. From 1989-1994 midazolam intravenous conscious sedation (ICS) was administered in 372 cases in the Department of Oral and Maxillofacial Surgery, County Hospital, Falun. This study presents data on the 298 patients. Although surgical removal of impacted wisdom teeth predominated, implant surgery, reduction of fractures and correction of anomalies were also carried out. Supplementary sedative premedication was rarely used. Most patients were treated under local anaesthesia. The mean dosage was 10.45 mg (range 1.25-40 mg). Mean dosage/kg was 0.15 mg (range 0.03-0.50 mg). The average duration of anaesthesia was 50 minutes. The average recovery time was 94 minutes. Three hundred and sixty-nine of 372 planned treatments were completed. No serious complications occurred. The patients were co-operative during surgery and were satisfied with the treatment. Compared with full anaesthesia this method required less resources and is a valuable complement in management of anxious patients undergoing oral surgery.

摘要

1987年,瑞典《牙科法案》修订,允许完成特定认证课程的瑞典牙医进行静脉镇静。咪达唑仑是一种苯二氮䓬衍生物,具有明显的镇静和催眠作用、强效遗忘作用、半衰期短且副作用少。1989年至1994年期间,法伦郡医院口腔颌面外科对372例患者实施了咪达唑仑静脉清醒镇静(ICS)。本研究展示了298例患者的数据。虽然拔除阻生智齿的手术占主导,但也开展了种植手术、骨折复位和畸形矫正。很少使用辅助性镇静术前用药。大多数患者在局部麻醉下接受治疗。平均剂量为10.45毫克(范围为1.25至40毫克)。平均剂量/千克为0.15毫克(范围为0.03至0.50毫克)。平均麻醉持续时间为50分钟。平均恢复时间为94分钟。372例计划治疗中有369例完成。未发生严重并发症。患者在手术过程中配合良好,对治疗满意。与全身麻醉相比,该方法所需资源更少,是口腔手术中焦虑患者管理的一种有价值的补充。

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