소아환자의 세보플루란 흡입진정시 미다졸람 병용 투여의 효과에 관한 예비연구
Effects of Midazolam with Sevoflurane Insufflation Sedation on Concomitant Administration in Pediatric Patients : A Preliminary Study
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초록
심한 치과적 공포와 불안으로 치과적 행동조절에 문제를 일으키는 환자의 경우, 진정법과 같은 약물적 행동 조절 방법이요구될 수 있다. 이번 연구에서는 소아 환자에서 세보플루란 흡입진정시에 추가적으로 0.1 mg/kg의 미다졸람을 근육주사하였을 때 진정 깊이와 심폐기능에 미치는 영향을 알아보기 위해 2013년 1월부터 2014년 3월 사이 본원에서 세보플루란 흡입진정 하에 치과치료를 받은 환자의 마취기록지를 후향적으로 분석하였다. 3~6세의 환자를 대상으로 하였으며, 세보플루란 단독 사용군이 18명, 미다졸람 병용 투여군이 18명이었다. 미다졸람 병용 투여군의 평균 엔트로피 값은 세보플루란 단독사용군에 비해 10정도 낮게 측정되었으나 통계적 유의성은 없었으며(p > 0.05), 분당 심박수와 평균동맥압은 미다졸람 병용투여군이 세보플루란 단독 사용군에 비해 높은 값을 보였다(p < 0.05). 즉, 0.1 mg/kg의 미다졸람 근육주사는 세보플루란흡입진정시 진정의 질을 높이는데 큰 도움이 되지는 않았으며, 추후 세보플루란 흡입진정과 병용 사용하기에 적절한 미다졸람의 용량을 결정하기 위한 추가적인 연구가 필요할 것으로 사료된다.
Abstract
Patients with extreme anxiety who are unable to cope with dental treatment under non-pharmacologicalbehavioral management method may require sedation, or other forms pharmacological behavioral managementmethod. The aim of this retrospective study was to investigate the effect of concomitant administration of 0.1mg/kg intramuscular midazolam with or without sevoflurane insufflation sedation on sedation depth andcardiopulmonary function in pediatric patients. We analysed the records of anesthesia on patients who receiveddental treatment under deep sedation using sevoflurane insufflation from January 2013 to March 2014. Thirtysixchildren, aged 3 to 6 years, undergoing dental treatment were sedated using either sevoflurane insufflationalone (Group S, n = 18) or a combination of intramuscular injection of 0.1 mg/kg midazolam plus sevofluraneinsufflation (Group SM, n = 18). Upon comparison, the average entropy value of group SM was lower than thatof group S, but there were no statistically significant difference between the two groups (p > 0.05). The averageheart rate and mean arterial pressure of group SM were higher than those of group S (p < 0.05). Concomitantintramuscular injection of 0.1 mg/kg midazolam with sevoflurane insufflation sedation is not sufficient to enhancethe quality of sedation.
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