摘要
目的:探究靶控输注丙泊酚联合瑞芬太尼在牙科恐惧症治疗中的应用。方法:回顾性分析2018年9月至2020年9月在佛山科学技术学院附属口腔医院择期行第三磨牙拔除术、牙科恐惧症的76例患儿的临床资料,按照麻醉方式的不同分为对照组(n=37,采用靶控输注丙泊酚进行镇静)和观察组(n=39,采用靶控输注丙泊酚联合瑞芬太尼进行镇静)。比较两组术中相关临床指标[如呼吸频率(RR)、血氧饱和度(SPO_(2))等],镇静相关反应情况[咽反射次数、视觉模拟疼痛评分(VAS)及Frankl依从量表(FCS)],丙泊酚输注情况以及术后改良成人牙科焦虑量表(MDAS)等指标。结果:(1)观察组RR[(17.64±3.71)次/分vs(15.58±3.85)次/分]、SPO_(2)[(96.61±1.23)%vs(95.81±2.22)%],均高于对照组(P<0.05);(2)观察组咽反射次数[(1.12±0.51)次vs(1.44±0.45)次]、VAS评分[(1.26±0.51)分vs(1.54±0.33)分]均低于对照组(P<0.05);(3)观察组FCS[(3.24±0.76)分vs(2.78±0.71)分]高于对照组(P<0.05);(4)观察组丙泊酚剂量[(68.24±10.26)μg/kg·min vs(76.23±12.21)μg/kg·min]、起效时把控血浆药物浓度[(1.49±0.48)g/mL vs(1.79±0.51)g/mL]均低于对照组(P<0.05);(5)观察组MDSA评分[(9.26±2.37)分vs(12.34±2.14)分]低于对照组(P<0.05)。结论:与单独靶控输注丙泊酚相比,丙泊酚联合瑞芬太尼可改善患儿对牙科治疗的恐惧,减少呼吸抑制和镇静相关反应,丙泊酚用量更少,依从性更高。
Objective:To explore the use of target-controlled infusion of propofol combined with remifentanil for tooth extraction in patients with dental phobia.Methods:Retrospectively included were the clinical data of 76 children who underwent elective third molar extraction and were with dental phobia in the Stomatological Hospital Affiliated to Foshan College of Science and Technology between September 2018 and September 2020.The subjects were divided according to anesthesia method into the control group(n=37,using target-controlled infusion of propofol for sedation)and study group(n=39,using target-controlled infusion of propofol plus remifentanil for sedation).The two groups were compared for clinical indicators during procedure[eg.respiratory rate(RR),oxygen saturation(SPO_(2))],sedation-related response[number of pharyngeal reflexes,visual analog score(VAS)of pain,and Frankl compliance scale(FCS)],Propofol infusion,and postoperative modified adult dental anxiety scale(MDAS).Results:Compared with the control group:(1)the study group had higher RR[(17.64±3.71)vs(15.58±3.85)times/min]and SPO_(2)[(96.61±1.23)%vs(95.81±2.22)%](P<0.05);(2)the study group were recorded with fewer pharyngeal reflexes[(1.12±0.51)vs(1.44±0.45)]and lower VAS score[(1.26±0.51)vs(1.54±0.33)](P<0.05);(3)the study group had higher FCS score[(3.24±0.76)vs(2.78±0.71)](P<0.05);(4)the study group showed less dose of propofol[(68.24±10.26)vs(76.23±12.21)μg/kg·min],target plasma concentration at drug action[(1.49±0.48)vs(1.79±0.51)g/mL](P<0.05);(5)the study group showed lower MDSA score[(9.26±2.37)vs(12.34±2.14)](P<0.05).Conclusion:Compared with target-controlled infusion of propofol alone,combination use of propofol and remifentanil can relieve dental phobia in children,reduce respiratory depression and sedation-related reactions,with less propofol dosage and higher compliance.
作者
叶嘉良
王志林
王娜
李周碧
陈玉婷
陈洁虹
Ye Jialiang;Wang Zhilin;Wang Na;Li Zhoubi;Chen Yuting;Chen Jiehong(Department of Anesthesiology,Stomatological Hospital Affiliated to Foshan College of Science and Technology,Foshan Stomatological Hospital,Foshan,Guangdong 528000,China;Department of Prosthodontics,Stomatological Hospital Affiliated to Foshan College of Science and Technology,Foshan Stomatological Hospital,Foshan,Guangdong 528000,China;Operating Theater,Stomatological Hospital Affiliated to Foshan College of Science and Technology,Foshan Stomatological Hospital,Foshan,Guangdong 528000,China;Department of Maxillofacial Surgery,Stomatological Hospital Affiliated to Foshan College of Science and Technology,Foshan Stomatological Hospital,Foshan,Guangdong 528000,China;Department of Pediatric Stomatology,Stomatological Hospital Affiliated to Foshan College of Science and Technology,Foshan Stomatological Hospital,Foshan,Guangdong 528000,China)
出处
《广州医科大学学报》
2021年第5期113-116,共4页
Academic Journal of Guangzhou Medical University
