치과적 장애환자의 치과치료를 위해 시행한 깊은 진정 : 전신마취와 비교한 통계적 고찰
CLINICO-STATISTICAL ANALYSIS OF DEEP SEDATION COMPARED WITH GENERAL ANESTHESIA AT THE CLINIC FOR THE DISABLED
서광석, 신터전, 김현정, 한희정, 한진희, 김혜정, 장주혜, 신혜영,
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서광석 ( Seo Kwang-Suk ) - 서울대학교 치과병원 치과마취과
신터전 ( Shin Teo-Jeon ) - 서울대학교 치과병원 치과마취과
김현정 ( Kim Hyun-Jeong ) - 서울대학교 치과병원 치과마취과
한희정 ( Han Hee-Jung ) - 서울대학교 치과병원 치과마취과
한진희 ( Han Jin-Hee ) - 서울대학교 치과병원 치과마취과
김혜정 ( Kim Hye-Jung ) - 서울대학교 치과병원 치과마취과
장주혜 ( Chang Ju-Hea ) - 서울대학교 치과병원 장애인구강진료실
신혜영 ( Shin Hye-Young ) - 서울대학교병원 마취통증의학과
KMID : 1144020090050010012
Abstract
Background : To do dental treatments successfully for dentally disabled patients who are unable to cooperate to procedures needs deep sedation (DS) or general anesthesia (GA). But there are some difficulties in selecting DS because of some disadvantages such as airway problem etc. But, if we select appropriate cases, DS would be better than GA. Methods : We reviewed total 238 cases of patients who had received dental treatments under GA or DS at the clinic for the disabled in Seoul National University Dental Hospital from November 2007 to February 2009. To compare anesthesia condition between DS and GA, we reviewed preanesthesia evaluation sheet, anesthesia or sedation records and PACU sheets retrospectively. Results : The number of DS cases was 25 (11%) and that of GA was 218 (89%). To maintain DS, intravenous propofol was infused with syringe pump (100%), and sevoflurane (134 cases) or propofol (13 cases) were used for sedation induction. Mean total treatment time for DS was 36 min and 2 hour 25 min for GA. The recovery time at PACU was 44 min for DS and 80 min for GA. There were no severe complications in DS, but 18 cases showed nausea and vomiting in GA. Conclusion : Deep sedation for disabled dental patients should be selected for effective behavioral control in conjunction with general anesthesia, considering duration and pain-evoking potentials of dental treatment and type and severity of patients’ disabilities altogether.
키워드
Deep sedation; General anesthesia; Dental treatment; Disabilities
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