Journal of The Korean Dental Society of Anesthesiology (대한치과마취과학회지)

The Korean Dental Society of Anesthsiology (대한치과마취과학회)
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Premedication of Oral Midazolam for Smooth Anesthesia Induction of Uncooperative Patients

협조에 어려움을 보이는 장애인 환자에서 전신마취 전 경구 Midazolam 전투약의 효과 분석

  • Lee, Brian Seong-Hwa (Department of Dental Anesthesiology, Seoul National University Dental Hospital) ;
  • Seo, Kwang-Suk (Department of Dental Anesthesiology, Seoul National University Dental Hospital) ;
  • Shin, Teo-Jeon (Department of Dental Anesthesiology, Seoul National University Dental Hospital) ;
  • Kim, Hyun-Jeong (Department of Dental Anesthesiology, Seoul National University Dental Hospital) ;
  • Han, Hyo-Jo (Department of Dental Anesthesiology, Seoul National University Dental Hospital) ;
  • Chang, Ju-Hea (Clinic for Persons with Disabilities, Seoul National University Dental Hospital)
  • 이승화 (서울대학교 치과병원 치과마취과) ;
  • 서광석 (서울대학교 치과병원 치과마취과) ;
  • 신터전 (서울대학교 치과병원 치과마취과) ;
  • 김현정 (서울대학교 치과병원 치과마취과) ;
  • 한효조 (서울대학교 치과병원 치과마취과) ;
  • 장주혜 (서울대학교 치과병원 장애인구강진료실)
  • Received : 2011.12.21
  • Accepted : 2011.12.27
  • Published : 2011.12.31
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Abstract

Background: Adult patients with intellectual disabilities often strongly resist the anesthetic administration for dental procedures. This study aimed to evaluate the effect of midazolam premedication in improving the cooperation level of patients who are likely to be combative and irritated during general anesthesia (GA) induction. Methods: The patients who had received dental treatment under ambulatory GA for more than two times were included. And we selected 13 patients total that needed physical restraint or ketamine IM prior to induction at the first GA, and were prescribed midazolam tablet (7.5-15 mg) at the following GA. We reviewed pre-anesthetic records and anesthesia records, and evaluated cooperative levels of patients (4 levels scale) during anesthesia induction and recovery time retrospectively. Results: All 13 patients (Male 11, Female 2) had severe mental disabilities. The average age of the patients was 24 ${\pm}$ 7 (13-37) years and their average weight was 58 ${\pm}$ 16 (34-91) kg. At the first GA, 10 patients needed physical restraint prior to induction (level 3). And 3 patients were so poorly cooperative that the induction procedure was performed after intramuscular injection of ketamine (level 4). But after the midazolam intake, 7 patients were willing to receive the anesthetic induction (level 1, 2), and 6 patient needed physical restraint (P < 0.05). There were no statistical differences in the duration of general anesthesia and postoperative recovery. Conclusions: Oral intake of midazolam was effective in improvement of cooperation without any complications.

Keywords

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