대한치과마취과학회지 (Journal of The Korean Dental Society of Anesthesiology)

  • 제10권1호
  • /
  • Pages.27-33
  • /
  • 2010
  • /
  • 1598-4044(pISSN)
  • /
  • 2383-7039(eISSN)
대한치과마취과학회 (The Korean Dental Society of Anesthsiology)
권호 표지

구역반사가 심한 환자의 임플란트 치료에서 프로포폴과 미다졸람을 이용한 정주진정법 -증례 보고-

Intravenous Sedation using Propofol and Midazolam in The Exaggerated Gag Reflex Patient's Dental Implant Treatment -A Case Report-

  • 오세리 (원광대학교 대전 치과병원 구강악안면외과) ;
  • 이준 (원광대학교 대전 치과병원 구강악안면외과)
  • O, Se-Ri (Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, Wonkwang University) ;
  • Lee, Jun (Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, Wonkwang University)
  • 투고 : 2010.04.01
  • 심사 : 2010.06.20
  • 발행 : 2010.06.27
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

The gag reflex is a physiologic reaction which safeguards the airway from foreign bodies. But, an exaggerated gag reflex can be a severe limitation to a patient's ability to accept dental care and for a clinician's ability to provide it. The overactive gag reflex can be due to psychological factors or physiological factors, or both. Psychological factors can include fear of loss of control and past traumatic experiences. A 58-year-old man, scheduled for extraction of left upper second molar, left lower second and third molar and implantation of left upper second molar, and left lower second molar had no specific underlying medical problems. He had exaggerated gag reflex. Dental treatment was successfully performed using intravenous sedation. Intravenous sedation with midazolam and propofol was a useful management technique for reflex control during dental treatment extended to the posterior regions in the oral cavity.

키워드

참고문헌

  1. Antoine T, Frederique S: Intravenous techniques in ambulatory anesthesia. Anesthesiology Clin N Am 2003; 21: 273-88. https://doi.org/10.1016/S0889-8537(02)00081-0
  2. Bassi GS, Humphris GM, Longman LP: The etiology and management of gagging: A review of the literature. J Prosthet Dent 2004; 91: 459-67. https://doi.org/10.1016/j.prosdent.2004.02.018
  3. Chaushu JJ, Becker A: Behavior management needs for the orthodontic treatment of children with disabilities. Eur J Orthod 2000; 22: 143-9. https://doi.org/10.1093/ejo/22.2.143
  4. Conny DJ, Tedesco LA: The gagging problem in prosthodontic treatment. J Prosthet Dent 1983a: 49: 601-4. https://doi.org/10.1016/0022-3913(83)90381-5
  5. Conny DJ, Tedesco LA: The gagging problem in prosthodontic treatment. J Prosthet Dent 1983b: 49: 757-61. https://doi.org/10.1016/0022-3913(83)90343-8
  6. Dies DF, Clarkston WK, Schratz CL: Intravenous ketorolac tromethamine versus meperidine for adjunctive sedation in upper gastrointestinal endoscopy: a pilot study. Gastointest Endosc 1996; 43: 6-9. https://doi.org/10.1016/S0016-5107(96)70251-1
  7. Fiske J, Dickinson CM: The role of acupuncture in controlling the gagging reflex using a review of ten cases. Br Dent J 2001; 190: 611-3.
  8. Guidelines for the use of sedation and general anesthesia by dentists. American Dental Association 2007.
  9. Harushi Y, Terumi A, Satoru I: Management of exaggerated gag reflex using intravenous sedation in prosthodontic treatment. Tohocu J Exp Med 2007; 212: 373-8. https://doi.org/10.1620/tjem.212.373
  10. Kramer RB, Braham RL: The managament of the chronic or hysterical gagger. J Dent Child 1977; 94: 111-4.
  11. Mack AO: Complete dentures. Br Dent J 1964; 116: 426-9.
  12. Meechan JG, Robb ND, Seymour RA: Pain and anxiety control for the conscious dental patient. 1998; Oxford: University press. 321-2.
  13. Rosted P, Bundgaard M, Fiske J: The use of acupuncture in controlling the gag reflex in patients requiring an upper alginate impression: an audit. Br Dent J 2006; 201: 721-5. https://doi.org/10.1038/sj.bdj.4814305
  14. Rudolph U, Antkowiak B: Molecular and neuronal substrates for general anesthetics. Nat Rev Neurosci 2004; 5: 709-20. https://doi.org/10.1038/nrn1496
  15. Saunders RM, Cameron J: Psychogenic gagging: identification and treatment recommendations. Compendium of Continuing Education in Dentistry 1997; 182: 109- 11.
  16. Veselis RA, Reinsel RA, Feshchenko VA: The comparative amnestic effects of midazolam, propofol, thiopental and fentanyl at equisedative concentrations. Anesthesiology 1997; 87: 749-64. https://doi.org/10.1097/00000542-199710000-00007
  17. Wright SM: Medical history, social habits and individual experiences of patients who gag with dentures. J Prosthet Dent 1982; 42: 474-8.
  18. Yagiela JA: Making patients safe and comfortable for a lifetime of dentistry. frontiers in office-based sedation. J Dent Educ 2001; 65: 1348-56.