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장애인 환자의 치과치료를 위한 진정법
Sedation for Dental Treatment of Patients with Disabilities

대한치과마취과학회지 2007년 7권 2호 p.114 ~ 119

빙정호, 황경균, 염광원, 심광섭, 박창주, 김현정, 서광석, 정세화, 전재윤,

소속 상세정보

빙정호 ( Bing Jung-Ho ) - 한양대학교 의과대학 치과학교실 구강안면외과
황경균 ( Hwang Kyung-Gyun ) - 한양대학교 의과대학 치과학교실 구강악안면외과
염광원 ( Yeom Kwang-Won ) - 서울대학교 치과대학 치과마취과학교실
심광섭 ( Shim Kwang-Sub ) - 한양대학교 의과대학 치과학교실 구강악안면외과
박창주 ( Park Chang-Joo ) - 한양대학교 의과대학 치과학교실 구강악안면외과
김현정 ( Kim Hyun-Jeong ) - 서울대학교 치과대학 치과마취과학교실
서광석 ( Seo Kwang-Suk ) - 서울대학교 치과대학 치과마취과학교실
정세화 ( Jung Se-Hwa ) - 한양대학교 의과대학 치과학교실 구강악안면외과
전재윤 ( Jeon Jae-Yun ) - 한양대학교 의과대학 치과학교실 구강악안면외과

KMID : 0980220070070020114

Abstract

Background: Dental disabilities mean the poor cooperation for dental treatment because of patient’s inherent disability, severe fear and anxiety, and communication problem. Sedation and general anesthesia are usually used for behavioral control in dentally disabled patients. In particular, sedation (conscious and deep) can help them to tolerate the proper dental treatment effectively and safely.

Methods: From March 2002 to September 2007, total 35 sedation were carried out in 33 patients (male : female = 20 : 13) with dental disabilities at Seoul National University Dental Hospital and Hanyang University Medical Center. Patients’ dental charts and sedation records were retrospectively reviewed.

Results: Tooth extraction (19 cases) was the most common dental treatment performed under intravenous sedation (30 cases). Occasionally, inhalation sedation using Sevoflurane 1-2% was adapted (5 cases). Deep sedation (28 cases) was carried out using midazolam 2-3 mg bolus injection and propofol infusion via TCI (4.2 0.9 mg/kg/h), and conscious sedation (7 cases) was carried out using midazolam bolus onlywithout severe complications. The duration of dental treatment was 25.5 12.3 min and that of sedation was 43.2 9.7 min.

Conclusion: Sedation for dentally disabledpatients should be selected for effective behavioral control in conjunction with general anesthesia, considering the duration and pain-evoking potentials of dental treatment, the type and severity of patients’ disabilities, and the experience of dental anesthesiologists altogether.