<原著>歯科における精神鎮静法の研究 : 第3報ミダゾラム静脈内鎮静法における術中鎮静維持のための追加投与方法

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We have actively used intravenous sedation with monitored conscious sedation care for cases of dental and minor oral surgical procedures under local anesthesia. Additional administration (time of injection and volume) of midazolam by intravenous injection was made to maintain optimum sedation during surgery, from the post-investigative stage of clinical cases to achieve satisfactory sedation during operation. Subjects for the statistical study provided dental treatment or surgery consent to the application of midazolam intravenous sedation, and 24 cases of ASA ps class I or II patients are included. Midazolam in intravenous injection by titration at the first injection established a standard of 0.075 mg/kg. Intravenous injection was established at 0.015 mg/kg/min. As a result, 0.072 ± 0.015 (mean ± SD) mg/kg midazolam was needed to ensure conscious and optimum sedation by a first injection. However, additional midazolam was injected before and after the local anesthesia injection (first additional administration 56%, second additional administration 46%). The main reasons for additional midazolam administration were, increase in state anxiety assessment, stressors in the operation, movement, and speaking clearly. It is necessary to provide the first additional administration of 0.022 ± 0.009 mg/kg midazolam, 29.3 ± 6.1 minutes after the first injection. The second additional administration was 0.035 ± 0.015 mg/kg, 50.0 ± 9.7 minutes after the first injection. Operations for 6 cases of first attempt establishment lasted 33.8 ± 22.8 minutes. The 11 cases which needed a first additional administration had operation times of 46.4 ± 22.2 minutes, and 7 cases which needed a second additional administration had operation times of 63.3 ± 15.7 minutes. The results showed that the additional injection of one third of the first intravenous injection resulted in an extension of sedation for 50 minutes during operation. Taking account of time for sterilization and for the local anesthesia to take effect midazolam appears suitable for about 30 minute operation times.
北海道医療大学の論文
2000-12-30

<原著>歯科における精神鎮静法の研究 : 第3報ミダゾラム静脈内鎮静法における術中鎮静維持のための追加投与方法

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