• 제목/요약/키워드: sedation

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소아의 치과치료를 위한 진정법 (Sedation of the Pediatric Dental Patient)

  • 김지연
    • 대한치과마취과학회지
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    • 제14권4호
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    • pp.197-204
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    • 2014
  • Children's fear and anxiety may interfere with dental treatment. If a child is very young, pharmacologic management may need to be provided during a dental procedure. Although sedation is an everyday practice in pediatric dentistry, it is not easy to achieve successful outcomes with sedation. Moreover, sedation of children can be associated with respiratory risks. Providers of pediatric sedation should be very cautious about adhering to the principles. This article reviews nicely the guidelines and references for pediatric sedation and supports a safe sedation with favorable treatment results.

임상가를 위한 특집 2 - 치과영역에서 경구진정법의 활용 (The application of oral sedation in the field of dentistry)

  • 신터전
    • 대한치과의사협회지
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    • 제51권7호
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    • pp.389-397
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    • 2013
  • Sedation is frequently required to relieve anxiety in the field of dentistry. Among sedation techniques, oral sedation has been widely used because it is easy for administration and has a wide acceptability for dentists. This article discuss the pharmacology of oral sedatives and therapeutic considerations of these drugs, and finally how to manage apprehensive patients using oral sedation. Also, we recommend how pertinent drugs should be used to maintain an adequate level of sedation, not deep sedation

Midazolam 진정요법 시 Bispectral index (BIS) Monitoring 효과의 평가를 위한 혈장농도, 진정지수(Sedation Score) 사이의 상관 관계 분석 (RELATIONSHIP BETWEEN BISPECTRAL INDEX (BIS), SEDATION SCORE AND PLASMA CONCENTRATION FOR EVALUATION OF MONITORING EFFECT OF BISPECTRAL INDEX IN MIDAZOLAM SEDATION)

  • 박은진;염광원;김은석;김현정
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제29권3호
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    • pp.169-172
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    • 2003
  • Purpose : We examined the relationship between BIS, sedation score and plasma midazolam concentration to verify the usefulness of BIS to assess the patient's consciousness during sedation. Patients and Methods : Twenty-five young, healthy adult volunteers participated in this clinical study. Midazolam was administered intravenously up to 0.08 mg/kg to induce unconsciousness and we monitored the patient's physiological and conscious status until complete recovery from sedation. BIS and sedation score were measured before sedation, 10, 20, 30 minutes after midazolam administration. Plasma midazolam concentration was measured 10 minutes after midazolam administration. BIS was measured using A-2000 BISTM monitor (Aspect Medical Systems, USA) and the degree of sedation was evaluated with the sedation score. Results : The BIS score correlated with the sedation score (r = 0.676; P < 0.05). With the decreased plasma midazolam concentration, the correlation was better with sedation score (r = -0.656). Although BIS values did not correlate with calculated plasma concentration of midazolam (r = 0.467) at 10 minutes after midazolam administration, values after sedation were well distinguished from those before sedation. Conclusions : BIS is known for an effective predictor of patient's hypnotic state, and it is correlated with the sedation score. But, it doesn't always coincide with the clinical parameters of depth of sedation. So more attention is needed using BIS only during sedation, and it is advisable that the patient's consciousness is monitored with variable sedation score systems every several minutes.

Dexmedetomidine intravenous sedation using a patient-controlled sedation infusion pump: a case report

  • Chi, Seong In;Kim, Hyun Jeong;Seo, Kwang-Suk
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제16권1호
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    • pp.55-59
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    • 2016
  • Dental treatment under sedation requires various sedation depths depending on the invasiveness of the procedure and patient drug sensitivity. Inappropriate sedation depth may cause patient discomfort or endangerment. For these reasons, patient-controlled sedation (PCS) pumps are commonly used. Patients are able to control the sedation depths themselves by pushing the demand button after the practitioner sets up the bolus dose and lock-out time. Dexmedetomidine is an ${\alpha}$-2 adrenoreceptor agonist with sedative, analgesic, and anxiolytic properties. It has been widely used for sedation for its minimal respiratory depression; however, there are few studies on PCS using dexmedetomidine. This study assessed the applicability of dexmedetomidine to PCS.

통증치료를 위한 신경차단과 부위 마취시 Anesthesiologist Controlled Sedation과 Patient Controlled Sedation의 비교 (Comparison of Anesthesiologist Controlled Sedation and Patient Controlled Sedation during Neurolytic Pain Block and Regional Anesthesia)

  • 김익곤
    • The Korean Journal of Pain
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    • 제7권2호
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    • pp.199-204
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    • 1994
  • The purpose of this study is to evaluate the feasibility, advantages/disadvantages of patient-controlled sedation (PCS) compared to anesthesiologist-controlled sedation (ACS) during neurolytic pain block and regional anesthesia. Forty patients were divided randomly into two groups of 20 patients each. Group 1(ACS) received 0.01 $mg{\cdot}kg^{-1}$ intravenous midazolam and 0.5 ${\mu}g{\cdot}kg^{-1}$ fentanyl intravenously by anesthesiologist just before, 30, and 60 minutes after the procedure to acheive sedation; Group 2 (PCS) patients self-administered a mixture of midazolam (0.4 mg) and fentanyl ($20{\mu}g$) using a syringe type infusion pump (Terumo, Japan) to acheive sedation. Considering the dermographics of patients, the types and durations of procedure performed, the level of average sedation the comfort level were similar in both groups. But the doses of midazolam and fentanyl administerd in group 2 were smaller than those in group 1 (p<0.01). Patients in PCS group showed their level of sedation more proper than did those in ACS group. However, patients in ACS group rated their level of comfort higher than did those in PCS group. The findings of this study indicate that PCS using a combination of midazolam and fentanyl is a fafe and effective technique. More studies are, however, needed to determinc the best choice of drug(s), doses, lock-out intervals, and possible use of continuous infusion with patient-controlled sedation.

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한국 소아치과 전문의 수련과정의 진정법 실태조사 (A Survey of Sedation Practices in the Korean Pediatric Dentistry Residency Program)

  • 심연수;안소연
    • 대한치과마취과학회지
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    • 제13권3호
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    • pp.103-110
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    • 2013
  • Background: Recently the use of sedation by pediatric dentists in Korea is increased. This study describes training programs about sedation practices in Korean pediatric dentistry residency program. Methods: A questionnaire was filled in by participants of Korean Academy of Pediatric Dentistry on 17th-18th August, 2008. Also the data about sedation practices of the training institution is collected by phone call. Results: Seventy two percent of respondents used sedation. Most of them used sedation with agents under 25% of their patients. Distribution of ages in patients sedated with agents was 3 years, 4-5 years, under 2 years, 6-10 years, and more than 10 years. Determinative factors of using sedation were behavior management, number of visiting, amount of treatment and general condition, and oral route was the most favorable route. Sixty six percent of them have failed on sedation, and thity percent of them have rarely failed on sedation. Only fifty percent of dentists using sedation completed the cardiopulmonary resuscitation course. Conclusions: For safety, dentists using sedation need to be educated about emergency equipment and management. Especially medication dose, use frequency and the detail related to treatment procedure should be discussed carefully. Also putting a patient under general anesthesia and taking emergency measures should be discussed with Korean Dental Society of Anesthesiology.

Use of ADMSTM during sedation for dental treatment of an intellectually disabled patient: a case report

  • Chi, Seong In;Kim, Hyun Jeong;Seo, Kwang-Suk;Yang, Martin;Chang, Juhea
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제16권3호
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    • pp.217-222
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    • 2016
  • Dental treatment is often performed under general anesthesia or sedation when an intellectually disabled patient has a heightened fear of treatment or has difficulty cooperating. When it is impossible to control the patient due to the severity of intellectual disability, conscious sedation is not a viable option, and only deep sedation should be performed. Deep sedation is usually achieved by propofol infusion using the target controlled infusion (TCI) system, with deep sedation being achieved at a slightly lower concentration of propofol in disabled patients. In such cases, anesthesia depth monitoring using EEG, as with a Bispectral Index (BIS) monitor, can enable dental treatment under appropriate sedation depth. In the present case, we performed deep sedation for dental treatment on a 27-year-old female patient with mental retardation and severe dental phobia. During sedation, we used BIS and a newly developed Anesthetic Depth Monitor for Sedation (ADMS$^{TM}$), in addition to electrocardiography, pulse oximetry, blood pressure monitoring, and capnometry for patient safety. Oxygen was administered via nasal prong to prevent hypoxemia during sedation. The BIS and ADMS$^{TM}$ values were maintained at approximately 70, and dental treatment was successfully performed in approximately 30 min.

충남장애인구강진료센터에서 시행된 전신마취 및 진정법에 관한 실태조사 (A SURVEY OF GENERAL ANESTHESIA, SEVOFLURANE SEDATION AND INTRAVENOUS SEDATION IN CHUNGNAM DENTAL CLINIC FOR THE DISABLED)

  • 김승오
    • 대한소아치과학회지
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    • 제40권1호
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    • pp.28-39
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    • 2013
  • 전신마취 및 진정법은 소아 및 장애인에게 성공적 치과치료를 위해서 필수불가결하다. 이 연구의 목적은 충남장애인구강진료센터에 치과치료를 위해 시행된 전신마취와 진정법의 실태를 평가하기 위함이다. 2011년 1월부터 2012년 9월까지 전신마취, 세보플루란진정 및 정주진정을 받은 소아와 장애인 426명을 대상으로 조사분석하였으며 389명이 전신마취, 20명이 세보플루란진정 그리고 17명이 정주진정하에서 치과진료를 받았다. 전신마취의 비율이 두 진정법에 비해 높았다. 세보플루란진정은 소아환자의 외상처럼 짧고 간단한 치료에 유용하게 사용되었다. 정주진정은 공포와 불안을 가진 치과적장애환자에게 선택되었다. 세보플루란과 정주진정은 점차적으로 전신마취의 사용을 줄이고 치과적장애환자를 위한 유용한 방법이었다.

중환자에서의 진정 진통 치료 (Sedation in the Critically Ill Patients)

  • 김태형
    • Tuberculosis and Respiratory Diseases
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    • 제72권2호
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    • pp.117-123
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    • 2012
  • Optimal level of sedation and analgesia is important for the comfort and safety of critically ill patients. However, suboptimal sedation is relatively common in the intensive care unit (ICU) and it could cause prolonged mechanical ventilation and ICU stay, also increase delirium and ICU acquired weakness and resultant decreased survival. Therefore, accurate assessment of the level of sedation and analgesia, maintaining adequate level of sedation, and daily evaluation of each patient and following adjustment could be important treatment strategy in critically ill patients. Recently, the strategy for sedation in the ICU is changing toward the direction of lowering sedation level or even "no sedation" with concurrent use of analgesics and the use of ultra short acting analgesics could be helpful in some patients. Clinicians should be aware of the importance of algorithmic approach including daily interruption of sedative and assessment of sedation level and especially in the patients under mechanical ventilation, organizational approaches such as the 'ABCDE' bundle could improve the management of critically ill patients.

임상가를 위한 특집 1 - 흡입진정법 (Inhalation sedation In Dentistry)

  • 김승오
    • 대한치과의사협회지
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    • 제51권7호
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    • pp.382-388
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    • 2013
  • Inhalation sedation has may advantageous properties that make it a suitable choice for sedation in pediatric, disabled and many patients, either alone or in conjunction with other agents. We need review of Guideline on use of nitrous oxide for dental patients that make minimizing complication of sedation for safe and effective sedation. Conventionally, nitric oxide is used for inhalation sedation, nowadays sevoflurane can also be used due to easily titratable for controllable effect and less failure of sedation. Recently sevoflurane can be used to provide sedation as a sole agent in air or oxygen or in combination with nitrous oxide in dentistry.