Molecular genetic evaluation of the clinical effect of sedatives

镇静剂临床效果的分子遗传学评价

• 批准号: 20791559
• 负责人: FUJIWARA Shigeki
• 金额: $ 2万
• 依托单位: Asahi University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Young Scientists (B)
• 财政年份: 2008
• 资助国家: 日本
• 起止时间: 2008 至 2009
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-20791559/
• 关键词: 歯科麻酔学; 歯科麻酔; 鎮静度; BIS; 血漿濃度; PCR-RFLP; 遺伝子; 鎮静薬

Simultaneous injection of a local anesthetic and a sedative in the oral cavity to reduce and prevent complications associated with local anesthesia during dental treatment (e.g., hyperventilation syndrome and cerebral anemia symptoms) was first reported by Yoichi Kurasawa and his colleagues in 2000. However, there has been no detailed evidence regarding this anesthetic procedure. This year, we performed recording and analysis of vital signs following local injection of sedatives (mainly midazolam) in the oral cavity. Percutaneous arterial oxygen saturation, but not respiratory rate, heart rate or blood pressure, showed significant differences between the sedative and control groups. Plasma midazolam concentration reached the maximum level 5 minutes after injection (101.0 ± 31.1 ng/ml), and then decreased over time to an 80-minute value of 43.0 ± 14.5 ng/ml. BIS index as measured with a BIS monitor were significantly lower in the midazolam group than in the control group at the followin … More g time points: 10 (79.1 ± 4.7), 20 (64.6 ± 7.5), 30 (56.3 ± 15.0), 40 (58.1 ± 17.6), 60 (60.5 ± 24.6) and 80 (92.2 ± 5.8) minutes after infection. The minimum BIS index was recorded 30 minutes after injection. The demonstration of the detailed recording and analysis of blood concentrations and electroencephalographic changes was the most important achievement of the present study and should lead to the prevention of accidents and complications and the realization of safer dental treatment. The present results were presented at the 56th Annual Meeting of the Japan Society of Anesthesiologists (August 2009, Kobe, Japan). For the second research subject regarding differences in sedative effect related to the genomic DNA sequence, we purified DNA and analyzed for mutations in the GABAα6 receptor and cytochrome P450 3A subfamily genes using restriction fragment length polymorphism polymerase chain reaction; however, we have not found any significant correlation between these mutations and degree of sedation. We will continue to perform analyses to further clarify this. Less

在口腔内同时注射局部麻醉剂和镇静剂，以减少和预防牙科治疗中与局部麻醉相关的并发症(例如过度换气综合征和脑贫血症状)，最早是由仓泽洋一和他的同事于2000年报道的。然而，目前还没有关于这一麻醉程序的详细证据。今年，我们对口腔局部注射镇静剂(主要是咪达唑仑)后的生命体征进行了记录和分析。经皮动脉血氧饱和度，而不是呼吸频率、心率或血压，在镇静剂组和对照组之间显示出显著的差异。咪达唑仑的血药浓度在注射后5分钟达最大值(101.0±31.1 ng/ml)，然后随时间下降至80分钟的43.0±14.5 ng/ml。在接下来的…，咪达唑仑组的BIS指数明显低于对照组感染后10(79.1±4.7)、20(64.6±7.5)、30(56.3±15.0)、40(58.1±17.6)、60(60.5±24.6)、80(92.2±5.8)min。注射后30min记录最小BIS指数。对血药浓度和脑电变化的详细记录和分析是本研究最重要的成果，应有助于预防意外和并发症，实现更安全的牙科治疗。本研究结果发表在日本麻醉学家协会第56届年会上(2009年8月，日本神户)。对于与基因组序列相关的镇静效果差异的第二个研究对象，我们提取了DNA，并利用限制性片段长度多态性聚合酶链式反应分析了GABAGABAα6受体和细胞色素P4503A亚家族基因的突变；然而，我们没有发现这些突变与镇静程度之间有任何显著的相关性。我们将继续进行分析，以进一步澄清这一点。较少

项目成果

ミダゾラムの口腔内注射による鎮静効果に関する研究

咪达唑仑口腔注射液的镇静作用研究

• 发表时间: 2009
• 作者: Zushi Y;Noguchi K;Hashitani S;Sakurai K;Segawa E;Takaoka K;Toyohara Y;Tanaka N;Kishimoto H;Urade M;Tanaka N;藤原茂樹
• 通讯作者: 藤原茂樹