A Study of Recovery from Intravenous Sedation for Dental Treatment in the Elderly

老年人牙科治疗静脉镇静恢复的研究

• 批准号: 08672278
• 负责人: FUKUSHIMA Kazuaki
• 金额: $ 1.54万
• 依托单位: HOKKAIDO UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1996
• 资助国家: 日本
• 起止时间: 1996 至 1998
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-08672278/
• 关键词: THE ELDERLY; INTRAVENOUS SEDATION; BALANCE FUNCTION; RESPIRATORY FUNCTION; RECOVERY; DENTAL SURGERY; NIDAZOLAM; 精神鎮静法; プロポフォール; 神経鎮静法

The recovery of elderly patients from sedation and the time they were able to leave the hospital after injection were compared with those of young and middle-aged adults. To carry out this study, groups of 15 patients in each age group underwent dental treatment after single intravenous bolus sedation with midazolam.The parameters used to determine recovery were arterial saturation of oxygen (SpO2), force of hand grip, spirogram, addition test, and balance test. Parameters were examined as changes in volume, taking the control value (before dental treatment) as zero, and the changes in volume of the two groups were also compared.Midazolam was administered little by little until the optimal sedation level was obtained with no other incremental dose. The midazolam dose required for the elderly group was 60% of that needed for the young and middle-aged group. There were already significant differences between all control values of the two groups except for vital capacity and the balance t … More est with eyes open.In the elderly group, delay of recovery from sedation was seen for SpO2, hand grip, vital capacity, and the balance test using a feedback system via which patients could adjust their center of gravity by watching a trace on a display monitor. There were no significant differences in recovery between the groups for FEV1.0, the addition test and the balance test with eyes open and eyes closed.These results suggest that the elderly should be managed carefully, paying special attention to the decrease in respiratory muscle force under intravenous sedation. Some elderly patients swayed markedly when they tried to adjust their center of gravity slightly when watching the display monitor. This suggested that, in the elderly, the ability to adjust posture during movement rather than the ability to maintain posture decreases. However, even elderly patients could return home 2 hours after administration of midazolam when the optimal amount of the sedative was carefully administered, just like the young and middle-aged adults.The efficacy of and time of recovery from treatment with propofol, which has begun to be used recently for intravenous sedation during oral surgery and dental procedures, were also ascertained for elderly patients. The results suggested that propofol is a useful sedative for such procedures, especially for patients who have developed tolerance against benzodiazepine drugs as a result of long-term use, if the sedation is carried out under careful observation. Less

比较老年患者镇静恢复情况及注射后出院时间与中青年患者的差异。为了进行这项研究，每个年龄组15名患者在单次静脉推注咪唑安定镇静后进行牙科治疗，用于确定恢复的参数是动脉血氧饱和度（SpO2），握力，肺量图，加法试验和平衡试验。以对照值（治疗前）为0，以体积变化为指标，比较两组患者的体积变化情况，逐渐给予咪达唑仑直至达到最佳镇静水平，不再增加剂量。老年组所需咪达唑仑剂量为中青年组的60%。两组除肺活量和平衡力外，其他各项对照值均存在显著性差异。 ...更多信息 在老年组中，观察到SpO2、握力、肺活量和使用反馈系统的平衡测试从镇静中恢复延迟，通过反馈系统，患者可以通过观察显示器上的轨迹来调整他们的重心。FEV1.0、加法试验、睁眼与闭眼平衡试验恢复情况组间差异均无统计学意义，提示老年人静脉镇静时应谨慎管理，特别注意呼吸肌力下降。一些老年患者在观看显示器时，试图稍微调整重心时会明显摇晃。这表明，在老年人中，在运动过程中调整姿势的能力而不是保持姿势的能力下降。然而，即使是老年患者，只要谨慎地使用最佳剂量的咪达唑仑，也可以像年轻人和中年人一样，在服用咪达唑仑2小时后返回家中。最近开始在口腔手术和牙科手术中使用丙泊酚进行静脉镇静，对老年患者的疗效和恢复时间也进行了研究。结果表明，异丙酚是一种有用的镇静剂，特别是对病人谁已经开发出对苯二氮卓类药物的耐受性，由于长期使用，如果镇静进行仔细观察。少