快適な歯科治療を目指して―自律神経解析からみた歯科治療が患者におよぼす影響―

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Purpose: The dentists experience that the patient during dental treatment becomes unpleasant. For the dental patient It is thought that syncope, circle drifting occur by fear feeling for treatment and anxiety, needle implant, pain. We recorded autonomic nerve activity during dental treatment of the patient. We were aimed at reviewing whether autonomic nerve activity of the dentist patients took any kind of influence by the treatment.Methods: We investigated the influence that oral surgery treatment (extraction ofthird molar and minor surgery for the outpatients)gives autonomic nerve activity. We divided the patient into control group (only monitoring, groupC) and intravenous sedation group(by Midazoiam, group S). We observed systolic blood pressure and diastolic blood pressure by noninvasive measurement, heart rate, SpO2 (BP-88, Nippon Coline), heart rate variability (Tarawa/Win, CMS). We observed it pre-treatment (pre), after administration of sedative agent (sed: only S group), at th … More e time of a local anesthesia (la), local anesthesia five minutes later (post-la), extraction (ext), post-treatment (post). In search of a low frequency ingredient (LF) and a high frequency ingredient (HF),we evaluated LF/HF as sympathetic nervous activity, HF as parasympathetic nerve activity. We compared group S with group C.Results: The blood pressure did not have a change in group C by each measurement time, decreased sed in group S. The heart rate showed a rise tendency in post-la in both groups. The autonomic nerve activity did not accept a change in LF/HF and HF of each measurement time in group C. In group S, HF became a fall tendency by each measurement time after sed.Discussion: It was investigated the influence that the third molar extraction gave autonomous nerve activity of the patient. About a circulation change, the heart rate rise in post-la by both groups was thought about with influence of local anesthetibs. In addition, as a circulation inhibition effect by midazolam sedation, it was thought that the intravenous sedation was useful for decrease of blood pressure in sed in group S. The autonomous nerve activity that dentistry was under treatment was not able to be caught in this methods or a pain of a needte and a pain of treatment moved a body, and a record of autonomous nerve activity may have beenbninfluenced. However, when unconsciousness was caused at vein puncture with the dentistry treatment phobia patient, we were able to observe hypotension, bradycardrc circulation inhibition, and a slight LF/HF fall and a slight HF rise as autonomous nerve activity. To need vein puncture in intravenous sedation for stress relaxation, it was thought that consideration more was necessary so that an unpleasant symptom was not caused. Less