진정법을 이용한 치과치료 시 편도선의 크기가 행동에 미치는 영향
EFFECTS OF CHILDREN'S TONSIL SIZE ON THE BEHAVIOR DURING PEDIATRIC DENTAL SEDATION
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초록
본 연구에서는 진정법을 이용한 치과치료에서 소아환자의 편도선 크기가 진정법 중 환자의 행동에 미치는 영향을 평가하기위해 진정법으로 치과치료를 받은 소아환자 35명의 진정기록지를 분석하였다. 진정법은 chloral hydrate 50 mg/kg, hydroxyzine 1 mg/kg를 경구투여하고, 치료 중 50% 아산화질소-산소 흡입 진정 및 필요에 따라 midazolam의 점막하투여(0~0.3 mg/kg)를 병행하는 방법으로 시행되었으며, 편도선의 크기는 Brodsky 분류법을 이용하여 4그룹으로 분류하였다. 환자의 진정 기록지를 분석하여 다음과 같은 결과를 얻었다. 1. 진정법 중 행동 반응은 수면, 움직임, 울음, 전반적 행동 모두에서 편도선 크기가 클수록 낮은 지수(negative behavior)를 보였다(p<0.05). 2. 편도선의 크기는 진정법 중 구호흡과 유의한 연관성을 보였으나(p<0.05), 진정법 중 코골이, 기침과는 유의한 연관성을보이지 않았다(p>0.05). 3. 편도선의 크기가 큰 환자일수록 midazolam의 점막하투여량이 유의하게 증가하였다(p<0.05).
Abstract
The purpose of this study was to evaluate the effect of children’s tonsil size on the behavior during pediatric dental sedation. The sedation records of thirty five children were examined in this study. All the sedations had been performed using chloral hydrate/hydroxyzine, nitrous oxide/oxygen or/and submucosal midazolam, and the subjects were divided into 4 groups according to their tonsil size using Brodsky’s tonsil classification. The results were as follows:1. The patients with enlarged tonsils showed negative behaviors in all behavior rating aspects(sleep, movement,crying, overall behavior) during sedation than those with normal tonsils(p<0.05). 2. Enlarged tonsils were correlated with mouth breathing(p<0.05) but not with snoring and coughing(p>0.05)during sedation. 3. For the patients with enlarged tonsils, significantly higher doses of midazolam were administered during sedation than for those with normal tonsils(p<0.05).
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