대한치과마취과학회지 (Journal of The Korean Dental Society of Anesthesiology)

  • 제10권2호
  • /
  • Pages.209-213
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  • 2010
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  • 1598-4044(pISSN)
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  • 2383-7039(eISSN)
대한치과마취과학회 (The Korean Dental Society of Anesthsiology)
권호 표지

심한 치과공포증 환자에서 임플란트 식립을 위한 Propofol과 Remifentanil 진정법 -증례 보고-

Sedation for Implant Surgery using Propofol and Remifentanil in Severe Dental Phobia Patient -A Case Report-

  • 이정후 (서울대학교 치의학대학원 치과마취과학교실) ;
  • 서광석 (서울대학교 치의학대학원 치과마취과학교실) ;
  • 신터전 (서울대학교 치의학대학원 치과마취과학교실) ;
  • 김현정 (서울대학교 치의학대학원 치과마취과학교실)
  • Lee, Jung-Hoo (Department of Dental Anesthesiology, Seoul National University, School of Dentistry) ;
  • Seo, Kwang-Suk (Department of Dental Anesthesiology, Seoul National University, School of Dentistry) ;
  • Shin, Teo-Jeon (Department of Dental Anesthesiology, Seoul National University, School of Dentistry) ;
  • Kim, Hyun-Jeong (Department of Dental Anesthesiology, Seoul National University, School of Dentistry)
  • 투고 : 2010.12.20
  • 심사 : 2010.12.23
  • 발행 : 2010.12.31
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초록

Anxiety and fear is two main factors that keep patients from going to dental clinic. Especially, patients may feel implants operations are more traumatic. Intravenous conscious sedation for dental treatment can make patient comfortable and relaxable. Midazolam is more popular for sedation for dental treatment, but target-controlled infusion (TCI) of propofol and remifentanil is gaining wide popularity. A 54-year-old female patient who had severe dental phobia was referred to our dental hospital. She had past history of 2 times of hyperventilation and syncope during dental treatment. The patient showed a lot of dental anxiety and fear to dental treatments and stress reduction protocol was needed. We administered intravenous conscious sedation using target controlled infusion system with remifentanil and propofol. During sedation, we monitored the status of consciousness with bispectral index and vital signs. Dental treatment could be finished successfully without any problems.

키워드

참고문헌

  1. Anderson JA: State of the art respiratory monitoring for outpatient general anesthesia for oral surgery. Journal of Oral and Maxillofacial Surgery 1989; 47(Suppl 1): 50-1.
  2. Casagrande AM: Propofol for Office Oral and Maxillofacial Anesthesia: The Case Against Low-Dose Ketamine. Journal of Oral and Maxillofacial Surgery 2006; 64: 693-5. https://doi.org/10.1016/j.joms.2005.11.039
  3. Higgins M: Dental Anesthesiology - An Access to Care Issue. Alpha Omegan 2006; 99: 56-63. https://doi.org/10.1016/j.aodf.2006.06.005
  4. Holzman RS, Cullen DJ, Eichhorn JH, Philip JH: Guidelines for sedation by nonanesthesiologists during diagnostic and therapeutic procedures. J Clin Anesth 1994; 6: 265-76. https://doi.org/10.1016/0952-8180(94)90072-8
  5. Mackenzie N, Grant IS: Propofol for intravenous sedation. Anaesthesia 1987; 42: 3-6. https://doi.org/10.1111/j.1365-2044.1987.tb02936.x
  6. McNeil DW, Berryman ML: Components of ental fear in adults?" Behaviour Research and Therapy 1989; 27: 233-6. https://doi.org/10.1016/0005-7967(89)90041-7
  7. Mora CT, Torjman M, White PF: Effects of diazepam and flumazenil on sedation and hypoxic ventilatory response. Anesth Analg 1989; 68: 473-8.
  8. Muellejans B, Matthey T, Scholpp J, Schill M: Sedation in the intensive care unit with remifentanil/propofol versus midazolam/fentanyl: a randomised, open-label, pharmacoeconomic trial. Crit Care 2006; 10: R91. Epub 2006 Jun 15. https://doi.org/10.1186/cc4939
  9. Oei-Lim VL, White M, Kalkman CJ, Engbers FH, Makkes PC, Ooms WG: Pharmacokinetics of propofol during conscious sedation using target-controlled infusion in anxious patients undergoing dental treatment. Br J Anaesth 1998; 80: 324-31. https://doi.org/10.1093/bja/80.3.324
  10. Overly FL, Wright RO, Connor FA, Jay GD, Linakis JG: Bispectral analysis during deep sedation of pediatric oral surgery patients. Journal of Oral and Maxillofacial Surgery 2005; 63: 215-9. https://doi.org/10.1016/j.joms.2004.07.013
  11. Peden CJ: Sedation for dental and other procedures. Anaesthesia & Intensive Care Medicine 2008; 9: 334-7. https://doi.org/10.1016/j.mpaic.2008.06.003
  12. Powers KS, Nazarian EB, Tapyrik SA, Kohli SM, Yin H, van der Jagt EW, et al: Bispectral index as a guide for titration of propofol during procedural sedation among children. Pediatrics 2005; 115: 1666-74. https://doi.org/10.1542/peds.2004-1979
  13. Reilly CS: Anaesthesia in the dental chair. Current Anaesthesia & Critical Care 1992; 3: 6-10. https://doi.org/10.1016/S0953-7112(05)80113-9
  14. Rosenberg MB, Campbell RL: Guidelines for intraoperative monitoring of dental patients undergoing conscious sedation, deep sedation, and general anesthesia. Oral Surgery, Oral Medicine, Oral Pathology 1991; 71: 2-8. https://doi.org/10.1016/0030-4220(91)90511-A
  15. Skaret E, Soevdsnes EK: Behavioural science in dentistry. The role of the dental hygienist in prevention and treatment of the fearful dental patient. Int J Dent Hyg 2005; 3: 2-6. https://doi.org/10.1111/j.1601-5037.2004.00109.x
  16. Smith I, Avramov MN, White PF: A comparison of propofol and remifentanil during monitored anesthesia care. J Clin Anesth 1997; 9: 148-54. https://doi.org/10.1016/S0952-8180(96)00240-1
  17. van Wijk AJ, Hoogstraten J: Reducing fear of pain associated with endodontic therapy. Int Endod 2006; J 39: 384-8.
  18. Weightman WM, Zacharias M: Comparison of propofol and thiopentone anaesthesia (with special reference to recovery characteristics). Anaesth Intensive Care 1987; 15: 389-93.
  19. Weinstein P, Milgrom P, Getz T: Treating fearful dental patients: a practical behavioral approach. J Dent Pract Adm 1987; 4: 140-7.
  20. White PF: Intravenous anesthesia and analgesia: what is the role of target-controlled infusion? J Clin Anesth 1996; 8(3 Suppl): 26S-28S. https://doi.org/10.1016/S0952-8180(96)90008-2