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정맥하 진정요법에서 Midazolam 단독 사용과 Midazolam, Fentanyl 또는 Propofol 병용 요법의 비교
Comparison of the Use of Midazolam only with Midazolam Combined with Fentanyl or Propofol in IV sedation

대한치과마취과학회지 2008년 8권 2호 p.113 ~ 117

이동현, 김재원, 이상준, 김재현, 장태화, 안상헌, 장헌수,

소속 상세정보

이동현 ( Lee Dong-Hyun ) - 대구파티마병원 구강악안면외과
김재원 ( Kim Jae-Won ) - 대구파티마병원 구강악안면외과
이상준 ( Lee Sang-Jun ) - 대구파티마병원 구강악안면외과
김재현 ( Kim Jae-Hyun ) - 대구파티마병원 구강악안면외과
장태화 ( Jang Tae-Hwa ) - 대구파티마병원 구강악안면외과
안상헌 ( An Sang-Hun ) - 동국대학교 경주병원 구강악안면외과
장헌수 ( Jang Heon-Su ) - 제니스 치과의원

KMID : 0980220080080020113

Abstract

Background: The purpose of this study was to compare the use of midazolam only with midazolam with fentanyl or propofol in IV sedation.

Methods: 24 cases were divided to midazolam group (M group), midazolam + fentanyl group (MF group), midazolam + propofol group (MP group) and midazolam + fentanyl + propofol group (MFP group). In M group, 2 ml midazolam was injected at first, than at 2 minutes interval 1-2 ml injected continuously depending on the level of sedation. In MP, MFP groups, propofol was injected at the speed of 15-20 ml/hr by infusion pump. In this study, the sedation level was evaluated by using OAA/S scale. In each groups, the recovery time was measured until OAA/S scale score level was 5, and pre and postoperative blood pressure change was measured. Each group’s data was statistically analyzed using one-way ANOVA. If significant statistical difference were observed, Dunnet test was performed, and control group was M group.

Results: Pre and postoperative blood pressure change were not represent significant statistical difference in 4 groups (P value = 0.679 [systolic], P value = 0.206 [diastolic]). But recovery time were represent significant statistical difference (M group: 35.6, MF group: 32.5, MP group: 17.9, MFP group: 19.6 [P value = 0.002]). The result of Dunnet test on recovery time showed significant statistical difference on MF, MFP group when M group was control group. In MFP group, sedation was increased by using supplemental fentanyl, and postoperative pain control was dominant.

Conclusion: To achieve the effect of anxiolysis, analgesia, amnesia effectively, and short recovery time, MFP group is mostly recommended.