서울대학교 치과병원 장애인진료실의 외래환자마취 실태분석
Analysis on the outpatient anesthesia at the dental clinic for disabled in seoulnational university dental hospital
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참고문헌
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초록
치과적 장애인이란 치과진료 시 치과의사에게 자발적인 협조가 힘든 사람을 의미한다. 본 연구는 서울대학 치과병원 장애인진료실에서 치료받은 치과적 장애인 환자들의 임상진료 실태를 마취과적으로 분석하고 향후 장애인 치과치료에 대한 지침을 마련하고자 하였다. 1999년 1월부터 2002년 10월까지 서울대학교 치과병원 장애인진료실에 내원한 장애인 환자들을 대상으로 조사한 결과, 총 89명의 환자들에게 93건의 치과진료가 시행되었다. 환자의 대다수는 정신지체였고 전신마취 하 보존치료를 받았다. 주로 마취유도제는 thiopental, 근이완제는 vecuronium을 이용하였으며 산소, 아산화질소, enflurane을 함께 흡입시켜 마취를 유지하였다. 총 마취지속시간과 회복실 체류시간은 각각 164.4 ± 57.2 분과 106.2 ± 50.5 분이었고 회복 과정에서 심각한 합병증은 관찰되지 않았다. 본 연구는 외래환자마취에 기반한 서울대학교 치과병원 장애인진료실의 치료방침에 따라 특별한 문제없이 성공적인 마취가 가능하였음을 보여 주었다. 또한 증가하는 장애인 치과치료에 대한 수요를 충족시키기 위해서 적절한 시설과 인력을 갖춘 보다 많은 외래환자마취 센터의 필요성도 제시한다고 할 수 있다.
Abstract
Dentally disabled person means one who have difficulty in cooperating voluntarily with a dentist for routine dental care. Seoul National University Dental Hospital (SNUDH) Dental Clinic for Disabled has worked for them under outpatient anesthesia concept. The aim of this study was to determine the anesthetic characteristics of the patients attending for dental treatment at SNUDH Dental Clinic for Disabled in order to establish better future treatment plans. The data were drawn from the patients who visited SNUDH Dental Clinic for Disabled from January 1999 to October 2002. Total 93 dental treatments for 83 patients were enrolled in this study. Most patients had mental retardation and the conservative treatments were carried out under general anesthesia. Thiopental and vecuronium were mostly used for induction agent and neuromuscular blocker, respectively. Enflurane, with oxygen and nitrous oxide, was mostly used to maintain the anesthesia. Mean total anesthetic time was 164.4 ± 57.2 minutes and mean duration at the post-anesthetic care unit was 106.2 ± 50.5 min. Serious postoperative complications were not observed. These results showed our successful anesthetic outcomes without any severe side effect or complication and the needs of more outpatient centers for dental care for disabled.
참고문헌 (12)
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