[1]郁葱,周玭娉,席梦莹.儿童门诊口腔治疗常用镇静镇痛技术及风险防范[J].麻醉安全与质控,2019,3(03):133-136.[doi:10.3969/j.issn.2096-2681.2019.03.003]
 YU Cong,ZHOU Pinping,XI Mengying.Sedation and analgesia techniques and risk prevention commonly used in oral treatment of children’s outpatients[J].Perioperative Safety and Quality Assuance,2019,3(03):133-136.[doi:10.3969/j.issn.2096-2681.2019.03.003]
点击复制

儿童门诊口腔治疗常用镇静镇痛技术及风险防范()
分享到:

《麻醉安全与质控》[ISSN:2096-1245/CN:CN 61-1505/R]

卷:
3
期数:
2019年03期
页码:
133-136
栏目:
专家论坛
出版日期:
2019-06-11

文章信息/Info

Title:
Sedation and analgesia techniques and risk prevention commonly used in oral treatment of children’s outpatients
作者:
郁葱 周玭娉 席梦莹
重庆医科大学口腔医院麻醉科, 重庆 401146
Author(s):
YU Cong ZHOU Pinping XI Mengying
Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing 401146, China
关键词:
镇静镇痛 儿童门诊口腔治疗 风险防范
Keywords:
sedation and analgesia oral treatment of children’s outpatients risk prevention
DOI:
10.3969/j.issn.2096-2681.2019.03.003
摘要:
探讨儿童门诊口腔治疗常用的镇静镇痛技术及风险防范。 结合新近文献和我中心大量病例实践, 探讨多种镇静镇痛技术在儿童门诊口腔治疗中应用的优缺点及其风险防范策略。 口服药物镇静、 经鼻氧化亚氮吸入镇静、 经鼻黏膜途经给药镇静、 全凭吸入配合喉罩麻醉、 全凭静脉麻醉深度镇静、 静吸复合气管插管全麻均是儿童门诊口腔治疗中有效的镇静镇痛方法。 其适应证因患儿的年龄、 病情、 配合程度和人员技术水平、 设备等软硬件条件而异。 镇静镇痛技术是口腔舒适化医疗的有力保障, 实际应用中应合理选择镇静镇痛方案、 防范并发症, 确保舒适和安全。
Abstract:
To explore the sedative and analgesic techniques and risk prevention commonly used in oral treatment of children’s outpatients. Combining the recent literature with the practice of a large number of cases in our center, we explored the advantages and disadvantages of various sedative and analgesic techniques in oral treatment of children’s outpatients and their risk prevention strategies. Oral drugs to sedate, nitrous oxide inhalation by nasal to sedate, administrated route via nasal mucosa to sedate, total inhalation anesthesia combined with laryngeal mask, total intravenous anesthesia for deep sedation, and inhalation and intravenous general anesthesia combined with tracheal intubation are effective methods of sedation and analgesia in oral treatment for children’s outpatients. The indications vary depending on the age, conditions, and cooperative degrees of children, and software and hardware conditions such as technical level of staffs and equipment and so on. The sedative and analgesic techniques are powerful guarantees for oral comfort medical treatment. In practice, we should select the sedative and analgesic programs reasonably, prevent complications and ensure comfort and safety.

参考文献/References:

[1] CALTABIANO M L, CROKER F, PAGE L, et al. Dental anxiety in patients attending a student dental clinic[J]. BMC Oral Health, 2018, 18(1): 48.DOI: 10.1186/s12903-018-0507-5.
[2] YILDIRIM S, BAKKAL M, BULUT H, et al. Quantitative evaluation of dental anxiety indicators in the serum and saliva samples of children treated under general anesthesia[J]. Clin Oral Investig, 2018, 22(6): 2373-2380.DOI: 10.1007/s00784-018-2340-2.
[3] DU R Y, YIU C K Y, KING N M. Oral health behaviours of preschool children with autism spectrum disorders and their barriers to dental care[J]. J Autism Dev Disord, 2019, 49(2): 453-459.DOI: 10.1007/s10803-018-3708-5.
[4] CHANDRASHEKHAR S, S BOMMANGOUDAR J. Management of autistic patients in dental office: a clinical update[J]. Int J Clin Pediatr Dent, 2018, 11(3): 219-227.DOI: 10.5005/jp-journals-10005-1515.
[5] American Academy of Pediatrics, American Academy of Pediatric Dentistry, COTE C J, et al. Guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures: an update[J]. Paediatr Anaesth, 2008, 18(1): 9-10.DOI: 10.1111/j.1460-9592.2007.02404.x.
[6] DOBSON G R. Special announcement: Guidelines to the Practice of Anesthesia-Revised Edition 2019[J]. Can J Anesth, 2019, 66(1): 14-20.DOI:10.1007/s12630-018-1247-3.
[7] Guideline for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures: Update 2016[J]. Pediatr Dent, 2016, 38(6): 216-245.
[8] SAGO T, SHIIBA S, ANDO E, et al. Sedation with a combination of dexmedetomidine and midazolam for pediatric dental surgery[J]. Anesth Prog, 2018, 65(2): 124-126.DOI: 10.2344/anpr-65-03-14.
[9] ARAU'JO J O, MOTTA R H L, BERGAMASCHI C C, et al. Effectiveness and safety of oral sedation in adult patients undergoing dental procedures: protocol for a systematic review[J]. BMJ Open, 2018, 8(1): e017681.DOI: 10.1136/bmjopen-2017-017681.
[10] SANUKI T, MISHIMA G, KIRIISHI K, et al. Nitrous oxide inhalation sedation through a nasal high-flow system: the possibility of a new technique in dental sedation[J]. Anesth Prog, 2017, 64(3): 175-177.DOI: 10.2344/anpr-64-04-06.
[11] SOUTO P, ROBB N. Does relative analgesia with nitrous oxide reduce the number of general anaesthetic sessions and dental loss?[J]. Br Dent J, 2018, 224(6): 429-433.DOI: 10.1038/sj.bdj.2018.215.
[12] MADOUH M, BANIHANI A, TAHMASSEBI J F. Treatment outcomes of using inhalation sedation for comprehensive dental care[J]. Eur Arch Paediatr Dent, 2018, 19(1): 33-37. DOI: 10.1007/s40368-017-0318-4.
[13] KLUIJFHOUT W P, WELSING R T. Procedural sedation and analgesia with nitrous oxide for children in the emergency department [J]. Ned Tijdschr Geneeskd, 2017, 161(15): D992.
[14] MAHDAVI A, FALLAHINEJAD GHAJARI M, ANSARI G, et al. Intranasal premedication effect of dexmedetomidine versus midazolam on the behavior of 2-6-year-Old uncooperative children in dental clinic[J]. J Dent(Tehran), 2018, 15(2): 79-85.
[15] GREAVES A. The use of midazolam as an intranasal sedative in dentistry[J]. SAAD Dig, 2016, 32: 46-49.
[16] WOOD M. The safety and efficacy of intranasal midazolam sedation combined with inhalation sedation with nitrous oxide and oxygen in paediatric dental patients as an alternative to general anaesthesia[J]. SAAD Dig, 2010, 26: 12-22.
[17] LEE S, KIM J, KIM J, et al. The use of laryngeal mask airway in dental treatment during sevoflurane deep sedation[J]. J Dent Anesth Pain Med, 2016, 16(1): 49-53.DOI: 10.17245/jdapm.2016.16.1.49.
[18] ZHAO N, DENG F, YU C. Anesthesia for pediatric day-case dental surgery:a study comparing the classic laryngeal mask airway with nasal trachea intubation[J]. J Craniofac Surg, 2014, 25(3): e245-e248.DOI: 10.1097/SCS.0000000000000547.
[19] American Academy of Pediatric Dentistry. Clinical Affairs Committee-Sedation and General Aresthesia Subcommittee. Guideline on use of anesthesia personnel in the administration of office-based deep sedation/general anesthesia to the pediatric dental patient[J]. Pediatr Dent, 2012, 34(5): 170-172.
[20] CRAVERO J P. Risk and safety of pediatric sedation/anesthesia for procedures outside the operating room[J]. Curr Opin Anaesthesiol, 2009, 22(4): 509-513.DOI: 10.1097/ACO.0b013e32832dba6e.
[21] ZHAO N, WU Y J, YU C. Effect of intravenous nalbuphine on emergence agitation in children undergoing dental surgery under sevoflurane anesthesia[J]. Int J Clin Exp Med, 2018, 11(9): 10215-10222.
[22] 郁葱. 口腔门诊镇静镇痛技术及治疗前评估[M]. 北京: 人民卫生出版社, 2016.
[23] CHAO Z, HUANG G J, CONG Y. The effect of general anesthesia for ambulatory dental treatment on children in Chongqing, Southwest China[J]. Pediatr Anesth, 2017, 27(1): 98-105.DOI: 10.1111/pan.12983.

备注/Memo

备注/Memo:
收稿日期: 2019-01-21; 接受日期: 2019-03-12
基金项目: 重庆市卫生计生委2017年医学科研项目(2017ZDXM017)
作者简介: 郁葱, 主任医师, 博士, E-mail: yucongab@sina.com
通信作者: 郁葱, E-mail: yucongab@sina.com
更新日期/Last Update: 2019-06-15