Journal of the korean academy of Pediatric Dentistry (대한소아치과학회지)
- Volume 34 Issue 1
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- Pages.91-98
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- 2007
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- 1226-8496(pISSN)
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- 2288-3819(eISSN)
SEDATION EVALUATION USING BIS INDEX ASSESSMENT WITH AND WITHOUT THE ADDED SUBMUCOSAL MIDAZOLAM
점막하 Midazolam의 병용투여 시 BIS 분석을 이용한 진정 평가
- Lee, Young-Eun (Department of Pediatric Dentistry, Ewha Womans University Graduate School of Clinical Dentistry, Ewha Womans University) ;
- Park, Mi-Kyung (Department of Pediatric Dentistry, Ewha Womans University Graduate School of Clinical Dentistry, Ewha Womans University) ;
- Kim, So-Young (Department of Pediatric Dentistry, Ewha Womans University Graduate School of Clinical Dentistry, Ewha Womans University) ;
- Kim, Yun-Hee (Department of Pediatric Dentistry, Ewha Womans University Graduate School of Clinical Dentistry, Ewha Womans University) ;
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Jung, Sang-Hyuk
(Department of Preventive Medicine, College of Medicine, Ewha Womans University) ;
- Baek, Kwang-Woo (Department of Pediatric Dentistry, Ewha Womans University Graduate School of Clinical Dentistry, Ewha Womans University)
- 이영은 (이화여자대학교 임상치의학대학원 소아치과학교실) ;
- 박미경 (이화여자대학교 임상치의학대학원 소아치과학교실) ;
- 김소영 (이화여자대학교 임상치의학대학원 소아치과학교실) ;
- 김윤희 (이화여자대학교 임상치의학대학원 소아치과학교실) ;
-
정상혁
(이화여자대학교 의과대학 예방의학교실) ;
- 백광우 (이화여자대학교 임상치의학대학원 소아치과학교실)
- Published : 2007.02.28
Abstract
The aim of this study was to examine the difference of the depth of sedation using the Bispectral index assessment with and without the added submucosal Midazolam to oral Chloral hydrate and Hydroxyzine for pediatric patients. Twenty seven sedation cases were performed in this study Selection criteria included good health(ASA I), 2 to 6 years of age, the need for sedation to receive dental treatment including anesthesia, and restorative procedure over at least two teeth. Patients were randomly classified into one group taking oral Chloral hydrate(60 mg/kg) and Hydroxyzine(1 mg/kg) and the other group recieving Chloral hydrate(60 mg/kg), Hydroxyzine(1 mg/kg) and submucosal Midazolam(0.1 mg/kg). Nitrous Oxide(50%) was used for both group during sedation. Patients were monitored using a pulse oximeter and a Bispectral monitor. A behavior scale was rated as quiet(Q), crying(C), movement(M), or struggling(S) every 2 minutes watching a recorded videotape. Analysis showed a significant difference in mean Bispectral index and SD during sedation across two groups(P<0.001). The group of patients injected with submucosal Midazolam in addition to oral Chloral hydrate and Hydroxyzine showed a lower mean Bispectral index and a narrower SD. PR and SpO2 for both groups remained within the normal values. Submucosal Midazolam improved the sedation quality by deepening sedation depth without compromising safety and enabled the sedation pattern to be kept more stable.
Chloral hydrate (CH)와 Hydroxyzine의 경구 복용을 이용한 진정과 Midazolam을 점막하 주사로 추가 투여한 진정을 Bispectral(BIS) index를 이용하여 두 진정법의 진정 깊이의 차이를 비교 평가하고자 하였다. 모든 환아는 2세-6세 사이의 미국 마취과학회 신체평가 등급 I의 건강한 환아로 진정 요법이 요구되었으며 국소마취와 최소 2개 이상의 치아에 대한 수복 치료가 치료에 포함되었다. 무작위 방법으로 환아를 CH(60mg/kg)와 Hydroxyzine(1mg/kg)을 복용하는 군과 CH(60mg/kg)와 Hydroxyzine(1mg/kg)을 복용하고 점막하 주사로 Midazolam(0.1mg/kg)을 추가 투여하는 군으로 나누었다. 진정 요법 동안 Nitrous Oxide는 두 군 모두 50%로 유지하였다. 환아 행동 평가는 녹화된 비디오 테이프를 보며 매 2분마다 Behavior scale을 이용하여 quiet(Q), crying(C), movement(M), or struggling(S)으로 측정하였다. 두 군의 진정 깊이 비교 평가를 위해 치료가 시작된 시점부터 40분 동안 2분 간격으로 측정한 Pulse rate(PR), Saturation percentage of