협조에 어려움을 보이는 장애인 환자에서 전신마취 전 경구 Midazolam 전투약의 효과 분석
Premedication of Oral Midazolam for Smooth Anesthesia Induction of Uncooperative Patients
이승화, 서광석, 신터전, 김현정, 한효조, 장주혜,
소속 상세정보
이승화 ( Lee Seong-Hwa ) - 서울대학교 치과병원 치과마취과
서광석 ( Seo Kwang-Suk ) - 서울대학교 치과병원 치과마취과
신터전 ( Shin Teo-Jeon ) - 서울대학교 치과병원 치과마취과
김현정 ( Kim Hyun-Jeong ) - 서울대학교 치과병원 치과마취과
한효조 ( Han Hyo-Jo ) - 서울대학교 치과병원 치과마취과
장주혜 ( Chang Ju-Hea ) - 서울대학교 치과병원 장애인구강진료실
KMID : 0980220110110020125
Abstract
Background: Adult patients with intellectual disabilities often strongly resist the anesthetic administration for dental procedures. This study aimed to evaluate the effect of midazolam premedication in improving the cooperation level of patients who are likely to be combative and irritated during general anesthesia (GA) induction.
Methods: The patients who had received dental treatment under ambulatory GA for more than two times were included. And we selected 13 patients total that needed physical restraint or ketamine IM prior to induction at the first GA, and were prescribed midazolam tablet (7.5-15 mg) at the following GA. We reviewed pre-anesthetic records and anesthesia records, and evaluated cooperative levels of patients (4 levels scale) during anesthesia induction and recovery time retrospectively.
Results: All 13 patients (Male 11, Female 2) had severe mental disabilities. The average age of the patients was 24 7 (13-37) years and their average weight was 58 16 (34-91) kg. At the first GA, 10 patients needed physical restraint prior to induction (level 3). And 3 patients were so poorly cooperative that the induction procedure was performed after intramuscular injection of ketamine (level 4). But after the midazolam intake, 7 patients were willing to receive the anesthetic induction (level 1, 2), and 6 patient needed physical restraint (P < 0.05). There were no statistical differences in the duration of general anesthesia and postoperative recovery.
Conclusions: Oral intake of midazolam was effective in improvement of cooperation without any complications.
키워드
Cooperation; General anesthesia; Anesthesia Induction; Midazolam; Dental Treatment
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