右美托咪定滴鼻镇静在门诊老年患者拔牙术中的应用  

Application of intranasal dexmedetomidine sedation in tooth extraction of elderly outpatient

作　　者：杨阳[1,2,3] 李思思[1,2,3] 郁葱[1,2,3] 

机构地区：[1]重庆医科大学附属口腔医院整形美容中心,重庆400015 [2]口腔疾病与生物医学重庆市重点实验室,401147 [3]重庆市高校市级口腔生物医学工程重点实验室,401147

出　　处：《重庆医学》2015年第22期3053-3054,3057,共3页Chongqing medicine

基　　金：重庆市科学技术委员会科研项目一般项目(cstc2014jcyA10038);2013年重庆高校创新团队建设计划资助项目;重庆市高校市级口腔生物医学工程重点实验室资助项目

摘　　要：目的评价右美托咪定滴鼻结合笑/氧吸入镇静在老年患者拔牙术中的安全性和有效性。方法 60例门诊老年患者拔牙患者分成两组(n=30),Ⅰ组(笑/氧吸入镇静);Ⅱ组(右美托咪定滴鼻结合笑/氧吸入镇静)。记录患者基础值(T0)、局部麻醉时(T1)、拔牙时(T2)、拔牙后10min(T3)生命体征,Ramsay镇静评分,焦虑评分,视觉模拟评分法(VAS)评分,术后患者满意度评分。结果术后患者满意度Ⅱ组高于Ⅰ组(P<0.05)。T1时,Ⅱ组患者焦虑评分,VAS评分均低于Ⅰ组,差异有统计学意义(P<0.05);T2时,Ⅱ组患者镇静程度高,Ramsay镇静评分高于Ⅰ组(P<0.01),焦虑评分、VAS评分低于Ⅰ组(P<0.05)。T2时,Ⅱ组心率低于Ⅰ组(P<0.05)。结论右美托咪定滴鼻结合笑/氧吸入镇静可用于老年患者门诊拔牙术。Objective To evaluate the safety and efficacy of intranasal dexmedetomidine and nitrous oxide/oxygen inhalation sedation assisted in tooth extraction in elderly outpatients. Methods Sixty elderly patients who need tooth extraction were divided into two groups,with 30 patients in each group. The group Ⅰ was treated with nitrous oxide/oxygen inhalation sedation, and the groupⅡwas treated with intranasal dexmedetomidine and nitrous oxide/oxygen inhalation sedation. Recording those signs basis value（T0 ）, during the injection（T1 ）, during the extraction（T2 ）, 10 min after extraction（T3 ） .. vital signs, Ramsay sedation score, anxie- ty score, VAS pain score and patients degree of satisfaction. Results In group Ⅱ , patients degree of satisfaction were significantly higher than group I （P〈0.05） after operation. The VAS pain scores and anxiety scores of group Ⅱ were significantly lower than group T0 in T1 and T2 （P〈0.05）. In T2 ,group Ⅱ had lower heart rates （P〈0.05）. In T2 ,Ramsay score of group Ⅱ was higher than group Ⅰ （P〈0.01）. Conclusion Intranasal dexmedetomidine and nitrous oxide/oxygen inhalation sedation can be a safe and effective anesthetic method in tooth extraction of elderly patients.

关 键 词：右美托咪定 滴鼻 笑气 老年患者 拔牙术 

分 类 号：R614[医药卫生—麻醉学]