CAJ | 학술논문

目的：比较不同剂量的右美托咪啶与咪唑安定在口腔种植手术患者中的镇静效果。方法选择60例需行口腔种植牙的健康患者，随机分为6组，每组10例。1组（G1）单独使用高剂量咪唑安定；2组（G2）低剂量咪唑安定复合低剂量右美托咪啶；3组（G3）高剂量咪唑安定复合高剂量右美托咪啶；4组（G4）为低剂量咪唑安定复合高剂量右美托咪啶；5组（G5）为高剂量咪唑安定复合低剂量右美托咪啶；6组（G6）单独使用高剂量右美托咪啶。记录各组镇静前、手术中、手术结束时患者血压、心率、血氧饱和度。记录并比较各组局部麻醉（T1）、切开（T2）、备洞（T3）、缝合（T4）时患者Ramsay镇静评分（RSS）以及对T1~T4的记忆情况，离院前进行手术疼痛评分及患者满意度调查。结果 G3组收缩压在T1~T4时均低于G1、G2组（P<0.05）；G1组收缩压在T3、T4时高于G6组（P<0.05）。G3组术中心率低于术前（P<0.05）。T1~T4时G1组RSS评分最低；G2组多为2~3分；G3组镇静较深，多例达到5分；G4组以3~4分居多；G5组在T2时开始有部分达到5分；G6组在T1、T2时低于G3、G4、G5组，在T2时接近G4组。各组疼痛评分及麻醉手术满意度比较未见差异。结论联合使用右美托咪啶和咪唑安定镇静优于单独使用，低剂量咪唑安定联合高剂量右美托咪啶镇静效果及程度最满意。
목적：비교불동제량적우미탁미정여미서안정재구강충식수술환자중적진정효과。방법선택60례수행구강충식아적건강환자，수궤분위6조，매조10례。1조（G1）단독사용고제량미서안정；2조（G2）저제량미서안정복합저제량우미탁미정；3조（G3）고제량미서안정복합고제량우미탁미정；4조（G4）위저제량미서안정복합고제량우미탁미정；5조（G5）위고제량미서안정복합저제량우미탁미정；6조（G6）단독사용고제량우미탁미정。기록각조진정전、수술중、수술결속시환자혈압、심솔、혈양포화도。기록병비교각조국부마취（T1）、절개（T2）、비동（T3）、봉합（T4）시환자Ramsay진정평분（RSS）이급대T1~T4적기억정황，리원전진행수술동통평분급환자만의도조사。결과 G3조수축압재T1~T4시균저우G1、G2조（P<0.05）；G1조수축압재T3、T4시고우G6조（P<0.05）。G3조술중심솔저우술전（P<0.05）。T1~T4시G1조RSS평분최저；G2조다위2~3분；G3조진정교심，다례체도5분；G4조이3~4분거다；G5조재T2시개시유부분체도5분；G6조재T1、T2시저우G3、G4、G5조，재T2시접근G4조。각조동통평분급마취수술만의도비교미견차이。결론연합사용우미탁미정화미서안정진정우우단독사용，저제량미서안정연합고제량우미탁미정진정효과급정도최만의。
ObjectiveTo?compare?the?sedative?effects?of?different?doses?of?dexmedetomidine?(DEX)?and?midazolam?(MDZ)?in?dental?implant?surgery.?Methods???Sixty?patients?undergoing?dental?implantation?were?selected?and?divided?randomly?into?six?groups?(10?in?each?group).?In?group?1?(G1),?a?highdose?of?MDZ?alone?was?administered?intravenously.?In?group?2?(G2),?a?relatively?low?dose?of?MDZ?and?DEX?was?administered?intravenously.?In?group?3?(G3),?a?highdose?of?MDZ?and?DEX?was?ad-ministered?intravenously.?In?group?4?(G4),?a?lowdose?of?MDZ?and?a?highdose?of?DEX?were?administered.?In?group?5(G5),?a?highdose?of?MDZ?and?a?low?dose?of?DEX?were?administered.?In?group?6?(G6),?a?highdose?of?DEX?alone?was?administered?intravenously.?Blood?pressure?(BP),?heart?rate?(HR),?and?arterial?oxygen?saturation?values?were?measured.?Sedation?was?as-sessed?by?determining?the?Ramsay?sedation?scores(RSS)?during?infiltration?anesthesia?(T1),?incision?(T2),?cutting?(T3),?and?suturing?(T4).?Before?discharging?from?the?hospital,?patients?were?asked?if?they?remembered?the?T1?to?T4?procedures.?The?visual?analogue?scale?(VAS)?and?the?degree?of?patient?satisfaction?were?assessed?at?the?same?time.?Results???In?T1?to?T4,?the?systolic?blood?pressure?(SBP)?in?G3?was?the?lowest?and?was?significantly?different?from?that?in?G1?and?G2?(P<0.05).?In?G1,?the?SBP?was?higher?than?that?in?G6?at?the?T3?and?T4?points?(P<0.05).?HR?was?below?the?preoperative?(P<0.05)?in?the?G3?only.?RSS?was?the?lowest?in?G1?during?the?whole?procedure.?In?G2,?most?patients?obtained?scores?of?2–3.?In?G3,?sedation?was?deeper,?had?more?cases?of?up?to?5.?In?G4,?most?patients?obtained?scores?of?3–4.?In?G5,?some?patients?had?a?score?of?up?to?5.?The?RSS?in?G6?was?lower?than?that?in?G3?and?G4?or?G5?in?T1?to?T2,?closer?to?G4?in?T2.?An?evaluation?of?the?VAS?and?the?degree?of?patient?satisfaction?did?not?show?any?differences?among?the?groups.?Conclusion???The?combination?of?DEX?and?MDZ?is?superior?to?a?single?intravenous?injection.?Low-dose?MDZ?combined?with?high-dose?DEX?achieved?the?highest?quality?of?sedation?in?this?study.