瑞马唑仑在阻生牙拔除术中的应用  

Advantages of remimazolam for sedation in impacted tooth extraction

作　　者：巴凯 倪端 杜若冰 魏雪琴 Ba Kai;Ni Duan;Du Ruobing;Wei Xueqin(Dept.of Stomatology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;Dept.of Anesthesiology,Armed Police Corps Hospital of Henan,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院口腔医学中心,郑州450000 [2]武警河南总队医院麻醉科,郑州450000

出　　处：《华西口腔医学杂志》2024年第4期476-480,共5页West China Journal of Stomatology

基　　金：河南省科技攻关项目(232102310491)。

摘　　要：目的比较瑞马唑仑和咪达唑仑在阻生牙拔除术中的镇静效果,以期为牙科焦虑患者提供更加舒适的镇静治疗。方法采用前瞻性随机对照试验设计,将60例接受静脉镇静下颌阻生第三磨牙拔除术的患者平均分配到瑞马唑仑组或咪达唑仑组。患者在行神经阻滞麻醉前使用瑞马唑仑或咪达唑仑进行预先镇静,记录并分析镇静起效、术后苏醒及完全恢复时间,手术前后改良牙科焦虑量表(MDAS)评分,医患满意度,术后24 h不良反应发生率,不同时间点心率(HR)和平均动脉压(MAP)的变化趋势。结果与咪达唑仑组相比,瑞马唑仑组患者的镇静起效、术后苏醒及完全恢复时间显著缩短,术后MDAS评分显著降低,医患满意度显著提高,术后不良反应发生率降低,但差异无统计学意义。结论瑞马唑仑起效和恢复更快,缓解牙科焦虑效果更好,医患满意度更高,在牙科焦虑患者镇静治疗时具有明显的优势。Objective This study aims to compare the sedative effects of remimazolam and midazolam during impacted tooth extraction to provide a comfortable sedation treatment for patients with dental anxiety.Methods A prospective randomized controlled trial was conducted,in which 60 patients undergoing intravenous sedation for mandibular impacted third molar extraction were evenly divided into either the remimazolam or midazolam group.Prior to receiving a nerve blocker,the patients were sedated with remimazolam or midazolam.Various parameters were recorded and analyzed,including onset time,awakening time,recovery time,modified dental anxiety scale(MDAS)scores before and after surgery,patient-doctor satisfaction levels,postoperative side effects within 24 hours,heart rate(HR),and mean arterial pressure(MAP)at different time points.Results Compared with the midazolam group,patients in the remimazolam group demonstrated significantly shorter onset,awakening,and recovery times as well as lower postoperative MDAS scores and higher levels of patient-doctor satisfaction.Fewer postoperative side effects were reported in the remimazolam group,although the differences were not statistically significant.Conclusion The use of remimazolam demonstrates faster onset and recovery,superior efficacy in reducing dental anxiety,and enhanced satisfaction among patients and doctors,thereby presenting distinct advantages for sedation treatment for patients with dental anxiety.

关 键 词：瑞马唑仑 咪达唑仑 牙拔除术 牙科焦虑 

分 类 号：R782.054[医药卫生—口腔医学]