清醒镇静镇痛麻醉应用于全牙弓种植手术的疗效研究

doi:10.13701/j.cnki.kqyxyj.2023.06.011

摘要/Abstract

摘要： 目的:观察清醒镇静镇痛麻醉配合局部麻醉下行全牙弓种植手术的临床效果及患者术后恢复情况。方法:选取24例需行全牙列种植固定咬合重建治疗的患者,按照随机数字表法分成实验组及对照组,每组12例,全牙列种植手术过程中,实验组采用清醒镇静镇痛麻醉配合局部麻醉,对照组采用单纯局部麻醉,记录两组麻醉前(T0)、局部浸润麻醉(T1)、翻粘骨膜瓣(T2)、钻洞(T3)、缝合(T4)时的平均动脉压(MAP)、心率(HR)、指氧饱和度(SpO₂),记录两组T1~T4时的镇静评分(RSS),离院前进行术中疼痛评分,术后前3 d进行术后疼痛评分。结果:实验组T1~T4各时点MAP及HR均显著低于对照组(P<0.05);对照组MAP及HR随时点变化为升高趋势,实验组MAP及HR随时点变化为下降趋势;两组各时点SpO₂均无显著差异(P>0.05);实验组T1~T4各时点RSS评分均显著优于对照组(P<0.05),实验组术中及术后第1、2、3天疼痛评分均明显低于对照组(P<0.05);两组不良反应发生率无统计学差异(P>0.05)。结论:清醒镇静镇痛麻醉配合局部麻醉安全、有效,减少术中及术后疼痛,不良反应少,值得在复杂且操作时间长的种植手术,尤其是全牙列种植手术中应用。

关键词: 种植, 全牙弓, 清醒镇静镇痛, 麻醉

Abstract: Objective: To observe the clinical effect of full arch implantation under conscious sedation and analgesia combined with local anesthesia. Methods: Twenty-our patients who needed full arch implantation were randomly divided into the experimental group and control group, with 12 patients in each group. The experimental group used conscious sedation analgesia and local anesthesia, and the control group adopted pure local anesthesia. The mean arterial pressure (MAP), heart rate (HR), and digital oxygen saturation (SpO₂) of two groups were recorded before anesthesia (T0), local anesthesia (T1), flap (T2), drilling (T3), and suturing (T4). The sedation scores (RSS) at T1-T4 were recorded, the intraoperative pain scores were performed before leaving the hospital, and the postoperative pain scores were performed 3 days after the operation. Results: MAP and HR at each time point of T1-T4 in the experimental group were significantly lower than those in the control group (P<0.05). The changes of MAP and HR at any time point in the control group showed an increasing trend, while the changes of MAP and HR at any time point in the experimental group showed a decreasing trend. There was no significant difference in SpO₂ between two groups at each time point (P>0.05). The RSS scores of the experimental group were significantly better than those of the control group at each time point of T1-T4 (P<0.05), and the pain scores of the experimental group were significantly lower than those of the control group during operation and on the 1st, 2nd, and 3rd day after operation (P<0.05). There was no significant difference in the incidence of adverse reactions between two groups (P>0.05).Conclusion: Conscious sedation and analgesia anesthesia combined with local anesthesia is safe and effective, and can reduce intraoperative and postoperative pain, with less adverse reactions. It is worthy of application in surgery with complex and long operation time, especially in full arch implantation.

Key words: implantation, full arch, conscious sedation and analgesia, anesthesia

张丹丹, 季蒙, 王林虎. 清醒镇静镇痛麻醉应用于全牙弓种植手术的疗效研究[J]. 口腔医学研究, 2023, 39(6): 522-526.

ZHANG Dandan, JI Meng, WANG Linhu. Application of Conscious Sedation and Analgesia in Full Arch Implantation[J]. Journal of Oral Science Research, 2023, 39(6): 522-526.

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