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

比较老年患者的镇静恢复情况和注射后出院时间，并与中青年患者比较。为了进行这项研究，每个年龄组的15名患者在单次静脉注射咪达唑仑镇静后接受牙科治疗，用于确定恢复情况的参数包括动脉血氧饱和度(SpO2)、握手力、肺图、加法试验和平衡试验。以控制值(牙科治疗前)为零，以容量变化为指标，比较两组患者的容量变化。咪达唑仑点滴至最佳镇静水平，无其他增量剂量。老年组所需咪达唑仑剂量为中青年组所需剂量的60%。除肺活量和平衡t…外，两组所有控制值之间均已有显著差异在老年组中，SpO2、握力、肺活量和平衡测试的恢复延迟。通过反馈系统，患者可以通过观看显示器上的轨迹来调整他们的重心。FEV1.0、加法试验和闭眼平衡试验恢复情况差异无统计学意义，提示老年人应慎重管理，尤其要注意静脉镇静下呼吸肌力的下降。一些老年患者在观看显示屏时，当他们试图轻微调整重心时，他们的身体出现了明显的摇摆。这表明，老年人在运动过程中调整姿势的能力下降，而不是保持姿势的能力下降。然而，就像年轻人和中年人一样，即使是老年患者在仔细服用咪达唑仑后2小时也可以回家。异丙酚最近开始用于口腔手术和牙科手术中的静脉镇静，对老年患者的疗效和恢复时间也进行了确定。结果表明，如果在仔细观察的情况下进行镇静，异丙酚是一种有用的镇静剂，特别是对于长期使用苯二氮卓类药物而产生耐受性的患者。较少

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