DOI QR코드

DOI QR Code

A Survey of Non-Emergency and Emergency Deep Sedation using Sevoflurane Inhalation for Pediatric or Disabled Patients

세보플루란 깊은 진정의 응급과 비응급적 사용에 관한 실태조사

  • Kim, Seungoh (Department of Dental Anesthesiology, School of Dentistry, Dankook University)
  • 김승오 (단국대학교 치과대학 치과마취과학교실)
  • Received : 2013.12.17
  • Accepted : 2014.02.05
  • Published : 2014.02.28

Abstract

Deep sedation is considered for the dental treatment of pediatric or disabled patients who have severe anxiety or involuntary movement. Deep sedation using sevoflurane inhalation in emergency dental practice, therefore, is also preferred for fast induction and recovery. This survey consists of 121 people with pediatric or disabled patients who underwent dental treatment under deep sedation using sevoflurane inhalation from January 2013 to October 2013. Patients who were scheduled for deep sedation were classified into a non-emergency sevoflurane sedation group, whereas patients who underwent emergency sedation due to trauma and patients with disabled characteristics itself were classified into an emergency sevoflurane sedation group. Of 121 patients studied, 95 patients received dental care under non-emergency sedation, 26 patients received dental care under emergency sevoflurane sedation. The two groups were analyzed according to: gender; age; primary reason for sedation; duration of sedation; treatment time; induction methods; treatment information; and departments. Non-emergency sevoflurane sedation in pediatric or disabled patients was safe and effective for controlling the behavior. Emergency sevoflurane sedation was a useful method for younger pediatric patients with traumatic injury who need simple, short time emergency treatment. Deep sedation using sevoflurane inhalation not only will reduce the use of general anesthesia gradually but also will be a useful method to emergency treatment for pediatric or disabled patients.

심한 불안이나 불수의적인 움직임으로 행동조절이 어려운 소아와 장애인의 치과치료를 위해 깊은 진정법이 고려된다. 응급 치과진료에 있어 세보플루란 흡입을 이용한 깊은 진정이 빠른 유도와 회복으로 인해 선호된다. 2013년 1월부터 2013년 10월까지 세보플루란을 이용한 깊은 진정을 받은 소아와 장애인 121명을 대상으로 조사분석하였다. 깊은 진정법을 사전 계획한 환자군과 소아외상이나 장애인의 특성 등으로 응급으로 시행한 환자군을 비응급 세보플루란진정군과 응급 세보플루란진정군으로 나누었다. 비응급 세보플루란진정을 받은 환자는 95명이었고 응급 세보플루란진정을 받은 환자는 26명이다. 두 군간에 성별, 나이, 진정법을 시행한 이유, 유도방법, 진정시간 및 치료시간, 치료내용, 진료과를 비교분석하였다. 비응급 세보플루란진정은 소아와 장애인의 행동조절에 안전하고 효과적으로 사용되었고 응급 세보플루란진정은 외상을 입은 어린 소아환자의 짧고 간단한 치료에 유용하게 사용되었다. 세보플루란을 이용한 깊은 진정은 점차적으로 전신마취의 사용을 줄이고 소아와 장애인 환자의 응급 치과진료에 유용한 방법이었다.

Keywords

References

  1. Doh RM, Song YG, Kim SO : Use sevoflurane inhalation sedation for disabled dental treatment. J Korean Dental Society of Anesthesiology, 12:125-129, 2012. https://doi.org/10.17245/jkdsa.2012.12.2.125
  2. Frink EJ, Malan TP, Atlas T, et al. : Clinical comparison of sevoflurane and isoflurane in healthy patients. Anesth Analg, 74:241-245, 1992. https://doi.org/10.1213/00000539-199202000-00012
  3. Ji SE, Kim JS, Kim SO : Sevoflurane sedation using a nasal cannula in pediatric patients. J Korean Pediatr Dent, 40:186-192, 2013
  4. Kim SO, Kim YJ, Kim YS : Deep sedation with sevoflurane insufflated via a nasal cannula in uncooperative child undergoing the repair of dentalinjury. Am J Emerg Med, 31:894.e1-e3, 2013.
  5. Kim SO, Kim YJ, Shin TJ : Deep sedation with sevoflurane inhalation via a nasal hood for brief dental procedures in pediatric patients. Pediatr Emer Care, 29:926-927, 2013. https://doi.org/10.1097/PEC.0b013e31829ec4e9
  6. Kim SO : A survey of general anesthesia, sevoflurane sedation and intravenous sedation in chungnam denta clinic for the disabled. J Korean Pediatr Dent, 40:28-39, 2013.
  7. Nathan JE : Behabioral management straegies for young pediatric dental patients with disabilities. J Dent Child, 68:89-101, 2001.
  8. Allen GD, Sim. J : Full mouth restoration under general anesthesia in pedodontic practice, J Dent Child, 34:488-492, 1967.
  9. Grytten J, Holst D, Dyrberg L, et al. : Some characteristics of patients given dental treatment under general anesthesia. Acta Odontol Scand, 47:1-5,1989. https://doi.org/10.3109/00016358909004793
  10. Lee DW, Song JS, Lee JH, et al. : A survey of dental treatment under outpatient general anesthesia in department of pediatric dentistry and clinic for disabled at Yonsei university dental hospital. J Korean Pediatr Dent, 37:65-72, 2010.
  11. Patel SS, Goa KL. Sevoflurane. A review of its pharmacodynamic and pharmacokinetic properties and its clinical use in general anaesthesia. Drugs,51:658-700, 1996. https://doi.org/10.2165/00003495-199651040-00009
  12. Houpt M. Project USAP the use of sedative agents in pediatric dentistry: 1991 update. Pediatr Dent,15:36-40, 1993.
  13. Ross N, Drury N : Conscious sedation with sevoflurane. ATOTW 188, 188:1-5, 2010.
  14. Ganzberg S, Weaver J, Beck FM, McCaffrey G : Use of sevoflurane inhalation sedation for outpatient third molar surgery. Anesth Prog, 46:21-29, 1999.
  15. Lahoud GY, Averley PA : Comparison of sevoflurane and nitrous oxide mixture with nitrous oxide alone for inhalation conscious sedation in children having dental treatment: a randomised controlled trial. Anaesthesia, 57:446-450. 2002. https://doi.org/10.1046/j.0003-2409.2002.02569.x
  16. Sury MR, Harker H, Thomas ML : Sevoflurane sedation in infants undergoing MRI: a preliminary report. Paediatr Anaesth, 15:16-22, 2005. https://doi.org/10.1111/j.1460-9592.2005.01456.x
  17. De Sanctis Briggs V: MRI under sedation in newborns and infants: study of 640 cases using sevoflurane. Paediatr Anaesth, 15:9-15, 2005. https://doi.org/10.1111/j.1460-9592.2005.01360.x
  18. Seo KS, Shin TJ, Kim HJ, et al. : Clinico-statisticalAnalysis of Cooperation and Anesthetic Induction Method of Dental Patients with Special Needs. J Korean Dental Society of Anesthesiology 9:9-16,2009. https://doi.org/10.17245/jkdsa.2009.9.1.9
  19. Lee DW, Song JS, Lee JH, et al. : A survey of dental treatment under outpatient general anesthesia in department of pediatric dentistry and clinic for disabled at Yonsei university dental hospital. J Korean Pediatr Dent, 37:65-72, 2010.
  20. Kim HN, Baek BJ, Kim JK et al. : A survey of dental treatment under general anesthesia. J Korean Pediatr Dent, 33:317-322, 2006.
  21. Korean Dental Society of Anesthesiology : Dental Anesthesiology, 2nd edition, Koonja Publishing Company, 539, 607-619, 2010.
  22. Lee HS, Yang JW, Kim MJ, et al. : The result of the dental behavior treatment for the patients with the developmental disorder in seoul dental hospital for disabled. J Korean Association for Disablility an Oral Health, 6:84-93, 2010.
  23. Jung YJ, Lee KH, et al. : A Statistical Study Of The Dental Treatment Of Handicapped Patient Under General Anesthesia. J Korean Pediatr Dent, 19:303-312, 1992.
  24. Kum JE, No HS, Kim JM, et al. : A survey of general anesthesia in pediatric dental clinic at pusan national university. J Korean Association for Disablility an Oral Health, 3:11-16, 2007.
  25. Lee HJ, Kim YJ, Kim JW, et al. : Analysis on the outpatient anesthesia at dental clinic for disabled in seoul national university dental hospital. J Korean Pediatr Dent, 31:19-25, 2004.
  26. Kim JS, Kim SO, Yoo SH, et al. : Pediatric dentistry : manual for laboratory and clinical practice. Dae Han Narae publishing company, 247-251,2008.
  27. Pirwitz B, Schlender M, Enders A, Knauer O : Risks and complications anesthesia with intubation during dental treatment, Rev Stomatol Chir Maxillofac, 98: 387-9, 1998.
  28. Azar I : The response of patients with neuromuscular disorders to muscle relaxants: a review. Anesthesiology, 61:173-87,1984. https://doi.org/10.1097/00000542-198408000-00011
  29. Haywood PT, Karalliedde LD: General Anesthesia for Disabled Patients in Dental Practice. Anesth Prog,45:134-8, 1998.
  30. Seo KS, Shin TJ, Kim HJ, et al. : Clinico-statistical Analysis of Cooperation and Anesthetic InductionMethod of Dental Patients with Special Needs. J Korean Dental Society of Anesthesiology 9:9-16,2009. https://doi.org/10.17245/jkdsa.2009.9.1.9
  31. Kim SM : Dental care and the state of education and training of dentists for the handicapped. J Korean Pediatr Dent, 28:87-94, 2001.
  32. Montes RG, Bohn RA : Deep sedation with inhaled sevoflurane for pediatric outpatient gastrointestinal endoscopy. Journal of pediatric gastroenterology and nutrition, 31:41-46, 2000. https://doi.org/10.1097/00005176-200007000-00010
  33. Ling Yu, Hongwei Sun, Lan Yao, et al. : Comparison of effective inspired concentration of sevoflurane in preterm infants with different postconceptual ages. Pediatric Anesthesia, 21:148-152, 2010.
  34. Ganzberg S, Weaver J, Beck FM, McCaffrey G : Use of sevoflurane inhalation sedation for outpatient third molar surgery. Anesthesia Progress, 46:21-29,1999.
  35. Lee WH, Kim HJ, Yeum KW. Inhalational Deep Sedation Using Sevoflurane in Pediatric Dental Patients. J Korean Dental Society of Anesthesiology,4:90-95, 2004. https://doi.org/10.17245/jkdsa.2004.4.2.90
  36. Hosey MT : UK National Clinical Guidelines in Paediatric Dentistry. International Journal of Paediatric Dentistry, 12:359-372, 2002.

Cited by

  1. DENTAL TREATMENT USING TRIAZOLAM FOR THE MENTAL RETARDATION PATIENT : A CASE REPORT vol.11, pp.2, 2015, https://doi.org/10.12655/KADH.2015.11.2.76
  2. Use of Ketamine Hydrochloride for Pediatric Dental Patient at General Hospital vol.42, pp.1, 2015, https://doi.org/10.5933/JKAPD.2015.42.1.38