본문 바로가기
KERD
논문KCI 등재

소아환자 진정요법에서 chloral hydrate의 용량에 따른진정효과에 관한 연구

A comparison of the sedative effect on chloral hydrate dosagein the sedation of the pediatric dental patients

김영재|장기택|한세현|노승철
대한소아치과학회 (The Korean Academy Of Pediatric Dentistry)|2005.09|대한소아치과학회지 (Journal of the Korean academy of pediatric dentistry)|제32권 제3호|pp. 517-524

2

조회

0

다운로드

3

인용

0

참고문헌

키워드

Chloral hydrateSedation진정요법chloral hydrate약물의 용량행동양상저산소증Drug dosageOverall behaviorHypoxia
주제분류치의학

초록

Chloral hydrate는 소아환자 진정요법 시 hydroxyzine과 함께 가장 일반적으로 사용되는 약물임에도 불구하고 협조도가 불량한 어린 환아들의 행동조절을 위한 적절한 용량에 대한 의견이 분분한 실정이며, 또한 chloral hydrate를 제조사의 추천용량으로 사용 시 적절한 진정수준을 제공하는데 있어 잦은 실패를 초래하는 경우를 볼 수 있었다. 지금까지도, chloral hydrate를 사용함에 있어 약물의 용량에 따른 진정의 효과와 안전성 측면에서 많은 의견들이 존재한다. 본 연구는 소아환자 진정요법에서 chloral hydrate의 용량에 따른 진정의 효과와 안전성 측면에서 적절한 용량을 제시하고자, 소아환자 진정요법 시 제조사의 추천용량인 chloral hydrate 50mg/kg와 더 높은 용량인 70mg/kg을 hydroxyzine 2mg/kg와 50% N2O와 함께 투여하고, 진정의 효과와 안전성을 비교, 평가하여 다음과 같은 결론을 얻었다. 1. 수면, 울음, 움직임, 전체적인 행동양상에 대한 두 군 간의 비교, 평가에서 Ⅱ군(70mg/kg)이 Ⅰ군(50mg/kg)에 비해 네 가지 항목 모두에서 유의하게 더 높은 평균값을 나타내었다 (p<0.05). 2. 진정요법의 성공률에 대한 두 군 간의 평가에서 Ⅰ군은 38.7%, Ⅱ군은 71.0%의 성공률을 나타내었으며, 통계적으로 유의한 차이를 나타내었다(p<0.05). 3. 저산소증의 발생률에 대한 두 군 간의 평가에서 Ⅰ군은 22.6%, Ⅱ군은 19.4%의 발생률을 나타내었으며, 통계적으로 유의한 차이가 없었다(p>0.05).

Abstract

Despite the widespread use of chloral hydrate with hydroxyzine in the sedation of children, there is little agreement among pediatric dentists regarding its therapeutic dosage for the management of very uncooperative young children. Also, increasing concern has been raised with respect to its frequent failure to provide adequate levels of sedation when used according to the manufacturer's recommended dosage. Therefore, there has been many suggestions with respect to sedative effectiveness and safety of varying drug dosage, and some pediatric dental articles have advocated dosages exceeding manufacturer's recommendations. This study was performed to compare the effectiveness and safety in behavior management of the manufacturer's recommended dose of chloral hydrate(50mg/kg) with those of a higher dose(70mg/kg) used together with hydroxyzine(2mg/kg) and nitrous oxide(50%) when young children were sedated for dental treatment. The following results were obtained; 1. Ⅱ group(70mg/kg) displayed higher mean score compared to Ⅰgroup(50mg/kg) with regard to the degree of sleep, crying, movement and overall behavior. The difference was statistically significant(p<0.05). 2. In comparison of success rates for sedation between the two groups, Ⅰgroup and Ⅱ group showed 38.7% and 71.0% success rates respectively. An analysis of variance was statistically significant(p<0.05). 3. Comparing the occurrence rate hypoxia between the two groups, there were 22.6% and 19.4% occurrence of hypoxia in Ⅰ group and Ⅱ group. An analysis of variance was not statistically significant(p>0.05).

참고문헌 (32)

  1. "The therapeutic effectiveness of nitrous oxide & chloral hydrate administered orally,rectally and combined with hydroxyzine for pediatric dentistry", 53, pp.425~429 (1986)
  2. "A comparison of chloral hydrate and diazepam sedation in young children", 12, pp.33~37 (1990)
  3. "Comparison of triazolam to a chloral hydrate", hydroxyzine combination in the sedation of pediatric dental patients, 1990, pp.12, 283~287
  4. "Chloral hydrate sedation as a substitute for examination under anesthesia in pediatric ophthalmology", 89, pp.560~563 (1980)
  5. "Chloral hydrate and promethazine as premedicants for the apprehensi-ve child", 34, pp.327~331 (1967)
  6. "Behavioral assessment of two drug combinat- ion for oral sedation", 15, pp.186~190 (1993)
  7. "Chloral hydrate and its effects on multiple physiological parameter in yo-ung children:A dose response", 14, pp.171~177 (1992)
  8. "Chloral hydrate와 hydroxyzine을 사용한 진정요법의 성공률과 저산소증 의 발생에 관한 연구", 28, pp.337~343 (2001)
  9. "Comparison of a chloral hydrate", hydroxy-zine combination with and without meperidine in the sedation of pediatric dental pati-ents, 1983, pp.5, 252~256
  10. "Chloral hydrate and other drugs used in sedating young children:a survey of American Academy of Pedodontitics Diplomates", 5, pp.252~256 (1983)
  11. "Assessing chloral hydrate dosage for young children", 52, pp.364~369 (1985)
  12. "Conscious sedation of pediatric dental patients using chloral hydrate and nitrous oxide - a respective study of 382 sedations", pp.424~431 (1995)
  13. "Comparison of chloral hydrate-hydroxyzine with and without meperidine for management of the difficult pediatric patients", 54, pp.437~444 (1987)
  14. "Pulse oximetry monitoring of sedated pediatric dental patient", 32, pp.237~240 (1985)
  15. "A guide to patient management", pp.370 520~371 521 (1989), CV Mosby Co
  16. "Management of the refractory young child with chloral hydrate:dosage selection", 54, pp.22~29 (1987)
  17. "Should the parent remain with the child in the dental operatory", 29, pp.150~163 (1962)
  18. "Guideline for the elective use of pharmacologic conscious sedation and deep sedation in pediatric dental patient" (1997)
  19. "Chloral hydrate와 병용투여 시 hydroxyzine 용량에 따른 진정효과의 비교연구", 28, pp.430~440 (2001)
  20. "Textbook of pediatric dentistry", pp.404~431 (1980), Williams and Wilkins
  21. "Behavior management in dentistry for children", pp.146~155 (1975)
  22. "An update on anxiety and pain control in dentistry for children Part Ⅰ Control of anxiety", pp.25~28 (1979)
  23. "Conscious sedation of pediatric dental patients an investigation of chloral hydrate", pp.10~19 (1991)
  24. "Comparison of chloral hydrate with and without promethazine in the sedation of young children", 7, pp.41~46 (1985)
  25. "Effects of chloral hydrate on nitrous oxide sedation of children", 11, pp.26~29 (1989)
  26. "Oral premedication for the problem child:placebo and chloral hydrate", 1, pp.272~280 (1977)
  27. "Project USAP Part Ⅲ:Practice by heavy users of sedation in pediatric dentistry", 60, pp.183~185 (1993)
  28. "Pulse rate and oxygen saturation in children during routine dental procedures", 57, pp.279~283 (1990)
  29. "Monitoring of sedated pediatric dental patients", 55, pp.329~333 (1988)
  30. "Introduction to anesthesia the principle of safe practice" (1982)
  31. "The assessment of two oral sedation drug regimens in pediatric dental patients", pp.306~312 (1992)
  32. "An investigation of capnography and pulse oximetry as monitors of pediatric patients sedated for dental treatment", 11, pp.111~117 (1989)

이 간행물의 다른 논문 (22건)

표피성장인자가 치주인대 섬유 모세포의 증식과부착에 미치는 영향김연태, 이종은, 김성오, 최형준, 김종관pp. 395-402계승치의 결손을 동반한 상,하악 유구치의 다발성 유착에대한 증례보고정회훈, 이제호, 최형준, 김성오, 최병재pp. 403-408Forced eruption을 이용한 매복 전치의 치험례유승훈, 김종수, 공석배pp. 409-415소아환자의 Midazolam의 정맥투여 용량에 따른 진정 효과에 관한 비교연구김은영, 김종수, 유승훈pp. 416-426나노컴포지트에서 Acidulated Phosphate Fluoride적용에 따른 Streptococcus mutans 부착량 변화정영정, 김정욱, 장기택, 김영재pp. 427-436
원문 보기