摘要
目的探讨氯胺酮联合丙泊酚与氯胺酮联合右美托咪定两种镇痛方案在牙科焦虑症儿童拔除期间的镇静镇痛效果比较。方法选取2016年9月～2017年9月南方医科大学口腔医院口腔颌面外科收治的60例患有牙科焦虑症并拟行上颌埋伏多生牙拔除的儿童为研究对象,采用随机数字法分为2组,氯胺酮-丙泊酚组(KP组,氯胺酮:1 mg/kg+丙泊酚:1 mg/kg静脉给药),氯胺酮-右美托咪定组(KD组,氯胺酮:1 mg/kg+右美托咪定0.5μg/kg静脉给药),每组30人。记录术前和术后焦虑评分、术后疼痛评分、麻醉恢复评分、外科医生满意度(不良/中等/良好)、需要的额外药物、手术时间、拔牙数量及不良事件。同时在麻醉药物诱导后,每5 min记录SBP/DBP,HR,RR,RSS和SPO2值,记录2 h。结果 KP组及KD组在各个时间点心率、无创血压、药物重复次数、手术持续时间、麻醉恢复时间、镇静评分、手术前和术后焦虑评分、术后疼痛评分差异均无统计学意义(P>0.05)。KD组恶心呕吐发生率明显高于KP组(P<0.05)。KP组的外科医生满意度高于KD组,差异具有统计学意义(P<0.001)。结论 KP组和KD组在镇静镇痛作用上差异不大。但KP组较KD组恶心呕吐发生率更低,且外科医生满意度更高。KP组可能是牙科焦虑症儿童上颌埋伏多生牙拔除术中比较满意的镇静镇痛方案选择。
Objective To investigate the sedative and analgesic effects of ketamine-propofol combination and ketaminedexmedetomidine in the extraction of children with dental anxiety Methods The study was conducted at the Department of Oral and Maxillofacial Surgery,Faculty of Dentistry,Southern Medical University,Guangzhou,China,from September 2016 to September 2017,and comprised children who were due to undergo extraction of embedded supernumerary teeth in maxillary anterior.Of the 60 participants,there were 30(50%)in each group.Further,the ketamine-propofol group received 1mg/kg of ketamine and propofol,and the ketamine-dexmedetomidine group received 1mg/kg of ketamine+0.5μg/kg of dexmedetomidine.Preoperative and postoperative anxiety scores,postoperative pain scores,anesthesia recovery scores,surgeon satisfaction(bad/medium/good),additional medication required,operative time,number of extractions,and adverse events were recorded At the same time,SBP/DBP,HR,RR,RSS and SPO2 values were recorded every 5 min after induction of anesthetic drugs and recorded for 2 hours.Results No statistically significant differences were found in terms of heart rate,non-invasive blood pressures,duration of operation,anesthesia recovery time,sedation score,preoperative and postoperative anxiety score,postoperative pain score at any time and the number of drug repetitions(p>0.05).Nausea-vomiting was statistically higher in the ketamine-dexmedetomidine group(p<0.05).Conclusion There was no significant difference in sedative and analgesic effects between ketamine-propofol group and ketamine-dexmedetomidine group.However,ketaminepropofol had a lower rate of nausea and vomiting than ketamine-dexmedetomidine group,and the surgeon's satisfaction was higher.Combination of ketamine and propofol may be a satisfactory choice in the extraction of maxillary impacted supernumerary teeth in children.
作者
谢梦兰
魏娜
杨素真
蔡墅曼
耿瑞月
XIE Menglan;WEI Na;YANG Suzhen;CAI Shuman;Geng Ruiyue(Department of Oral and Maxillofacial Surgery,Guangdong Stomatological Hospital of Southern Medical University,Guangzhou 510000,China;Department of stomatology,Guangdong Provincial Corps Hospital,Chinese People's Armed Police Force,Guangzhou 510507,China)
出处
《分子影像学杂志》
2019年第1期104-107,共4页
Journal of Molecular Imaging
