口服咪唑安定镇静术在儿童口腔科临床应用的效果评价  

Clinical evaluation of oral midazolam sedation for dental treatment in children

作　　者：夏斌[1] 刘克英[2] 王春丽[1] 孙利军[1] 葛立宏[1] 

机构地区：[1]北京大学口腔医学院.口腔医院儿科,北京100081 [2]北京大学口腔医学院.口腔医院麻醉科,北京100081

出　　处：《北京大学学报（医学版）》2010年第1期78-81,共4页Journal of Peking University:Health Sciences

摘　　要：目的:在门诊对儿童实施口服咪唑安定镇静术下的口腔治疗,观察镇静效果,并对各相关指标进行观察评价。方法:选择在门诊常规条件下进行治疗时按Venham行为表现分类属于极不配合或无有效交流的23名4～14岁身体健康的儿童(ASAⅠ)为研究对象,共进行了45人次的口服咪唑安定(0.15～0.70 mg/kg)镇静下治疗。每次镇静治疗时记录患者的心率、血氧饱和度、呼吸频率、镇静和行为分度,治疗结束时记录患者及其家长对镇静方式的满意度和接受度。结果:23人中男孩为19人,女孩4人,平均年龄6.2岁。在所有的45人次治疗中,患者的生命体征平稳、安全,施治医师对其中40人次的镇静效果满意并完成了预定的治疗,3名儿童的镇静效果不理想转为全身麻醉下治疗,只有2名儿童的家长对再次镇静下治疗提出异议。7名按期复查的儿童中有6名能接受常规条件下的口腔诊疗。结论:儿童口腔治疗时口服镇静是一种有效的方法,可以使一部分常规治疗有困难的病例顺利接受治疗,有广阔的应用前景。Objective：To assess the safety,effectiveness and acceptability of oral midazolam sedation for dental treatment in children.Methods： Twenty-three health children aged 4 to 14（ASA Ⅰ）,who were classified as 4 or 5 by modified Venham＇s clinic anxiety and cooperative behavior rating scale,referred for dental treatment were included in the study.Each child was treated under sedation with oral midazolam（0.15-0.70 mg/kg）,and totally 45 sedations were conducted.At each visit,heart rate,arterial oxygen saturation,respiration rate,sedation and behavioral scores were recorded.The level of acceptance and satisfaction of the patients and their guardians were recorded after the treatment.Results： Among the 23 children,19 were boys and 4 were girls with mean age of 6.2 years old.In all the 45 treatments,the heart rate,respiratory rate and arterial oxygen saturation levels were within acceptable clinical limits.Forty planned treatments were completed satisfactorily.Oral sedation was ineffective in 3 children,and they were treated under general anesthesia.Only 2 guardians refused to have oral midazolam sedation again.Six of seven children who had regular dental check-up could be treated under normal condition.Conclusion： Oral midazolam（0.15-0.70 mg/kg） could be a safe and acceptable approach of sedation for pediatric dental patients.

关 键 词：麻醉 牙科 投药 口服 催眠药和镇静药 儿童 

分 类 号：R614[医药卫生—麻醉学]