Analysis of the effect of oral midazolam and triazolam premedication before general anesthesia in patients with disabilities with difficulty in cooperation
임선우, 소은선, 윤혜주, 감명환, 장주혜, 이한빈, 김현정, 서광석,
소속 상세정보
임선우 ( Lim Seon-Woo ) - Seoul National University School of Dentistry Department of Dental Anesthesiology
소은선 ( So Eun-Sun ) - Seoul National University Dental Hospital Department of Dental Anesthesiology
윤혜주 ( Yun Hye-Joo ) - Seoul National University Dental Hospital Department of Dental Anesthesiology
감명환 ( Karm Myong-Hwan ) - Seoul National University Dental Hospital Department of Dental Anesthesiology
장주혜 ( Chang Ju-Hea ) - Seoul National University Dental Hospital Special Care Clinic
이한빈 ( Lee Han-Bin ) - Seoul National University Dental Hospital Department of Oral and Maxillofacial Surgery
김현정 ( Kim Hyun-Jeong ) - Seoul National University School of Dentistry Department of Dental Anesthesiology
서광석 ( Seo Kwang-Suk ) - Seoul National University School of Dentistry Department of Dental Anesthesiology
Abstract
Background: When performing dental treatment under general anesthesia in adult patients who have difficulty cooperating due to intellectual disabilities, anesthesia induction may be difficult as well. In particular, patients who refuse to come into the dental office or sit in the dental chair may have to be forced to do so. However, for adult patients with a large physique, physical restraint may be difficult, while oral sedatives as premedication may be helpful. Here, a retrospective analysis was performed to investigate the effect of oral sedatives.
Methods: A hospital-based medical information database was searched for patients who were prescribed oral midazolam or triazolam between January 2009 and December 2017. Pre-anesthesia evaluation, anesthesia, and anesthesia recovery records of all patients were analyzed, and information on disability type, reason for prescribing oral sedatives, prescribed medication and dose, cooperation level during anesthesia induction, anesthesia duration, length of recovery room stay, and complications was retrieved.
Results: A total of 97 patients were identified, of whom 50 and 47 received midazolam and triazolam, respectively. The major types of disability were intellectual disabilities, autism, Down syndrome, blindness, cerebral palsy, and epilepsy. Analyses of changes in cooperation levels after drug administration showed that anesthesia induction without physical restraint was possible in 56.0% of patients in the midazolam group and in 46.8% of patients in the triazolam group (P = 0.312).
Conclusions: With administration of oral midazolam or triazolam, general anesthesia induction without any physical restraint was possible in approximately 50% of patients, with no difference between the drugs.
키워드
Dental Treatment; General Anesthesia; Intellectual Disability; Midazolam; Sedative Premedication; Triazolam
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