Chloral hydrate/Hydroxyzine과 Midazolam/Meperidine의 경구 투여 진정효과에 관한 비교 연구
A comparative study of chloral hydrate/hydroxyzine versus midazolam/meperidene as oral conscious sedative regimens
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본 연구의 목적은 소아 환자의 치과 진료를 위한 진정요법 시 chloral hydrate와 hydro-xyzine의 경구 투여와 midazolam과 meperidine의 경구 투여간의 임상적인 진정효과 및 합병증 발생 여부를 비교하는 것이다. 삼성서울병원 소아치과를 내원한 환아 중 ASA I 또는 II에 해당하는 4세 미만의 아동 15명을 대상으로 하여 한 달여 간격으로 두 차례에 걸친 진정요법을 시행하였다. 2회의 진정요법 중 1회는 chloral hydrate (60mg/kg)/ hydroxy-zine(25mg)을 경구 투여하고 나머지 1회는 midazolam(1mg/kg)/ meperidine(1mg/kg)을 경구 투여하였으며 투여 순서는 무작위로 정하였다. 두 차례 모두 N2O-O2 흡입진정을 병용하였다. 각 치료과정에 따른 진정효과는 Houpt Scale(수면, 움직임, 울음, 전반적인 행동 지수)로 측정하였고 pulse oximeter를 이용하여 저산소증의 유무를 비교, 평가하고 약물 투여 후 구토의 여부를 함께 평가하여 다음과 같은 결과를 얻었다. Chloral hydrate와 hydroxyzine을 경구 투여한 군이 midazolam과 meperidine을 경구 투여한 군보다 전반적인 행동 지수에서 통계학적으로 유의하게 우수한 결과를 보였으며 어느 군에서도 저산소증은 보이지 않았다. 본 연구에서는 chloral hydrate와 hydroxyzine의 경구 투여가 midazolam과 meperidine의 경구 투여보다 우수한 진정효과를 보이는 것으로 판단된다.
Abstract
The purpose of this study was to compare the efficacy and complications of two oral sedative regimens, chloral hydrate(60mg/kg)/hydroxyzine(25mg) versus midazolam (1mg/kg)/meperidine(1mg/kg) for the sedation of pediatric dental patients. Fifteen patients(mean age 36.2 months, range 24-47 months), ASA Class I or II, who needed at least two restorative dental procedures were selected in this double-blind, randomized study. All subjects were randomly assigned to receive either chloral hydrate/hydroxyzine or midazolam/meperidine and 50% N2O/O2 was administered at each appointment. Behavior assessment(sleep, movement, crying, overall behavior) was made using Houpt Sedation Rating Scale and physiologic parameters(pulse rate, oxygen saturation) were monitored using pulse oximeter. The incidence of hypoxia(SpO2 90% or less, at least 10s duration) and vomiting was recorded. Patients sedated with chloral hydrate/hydroxyzine showed significantly better overall behavior score than patients sedated with midazolam/meperidine. There was no clinically significant difference in the incidence hypoxia and vomiting. It was concluded that oral administration of chloral hydrate/hydroxyzine is more effective than midazolam/meperidine for the sedation of pediatric dental patients.
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