塩酸デクスメデトミジンによる静脈内鎮静法が聴覚性記憶に及ぼす影響

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概要

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• The amnesia effect by intravenous sedation produces an elimination of unpleasant memory in dental treatment that becomes profits for a patient. In this research, the memory was investigated after auditory memory loads in order to understand the amnesia effect and recovery in the intravenous sedation by Dexmedetomidine hydrochloride (DEX). Moreover, the relations between memory and clinical sedation levels (OAA/S Scale) or BIS values were investigated to judge the recovery of memory. Thirty-five volunteers were divided into a thirty persons' DEX administration group and a five persons' control group. As control in the DEX administration group, five auditory memory subjects were given from headphones at 15 seconds before DEX administration, so that the subjects might repeat and memorize them. According to the recommendation method, DEX was continuously prescribed in maintenance doses (0.4μg/kg/hr) following in initial dose (6μg/kg/hr) for 10 minutes. The auditory memory tasks were given 3 times every 5 minutes after 3 minutes from the maintenance administration start, and a further 12 times every 10 minutes after the DEX administration stop. After awaking from sedation, the names of all the memorized subjects were written out. Throughout research, blood pressure, heart rate, SpO_2, and BIS values were measured and recorded. Furthermore, in the control group, saline was prescribed for the patient instead of DEX, and set to the same schedule. As results, the rate of the memory decreased significantly by DEX, and was maintained falling even after the DEX administration stop. The rate of the memory recovered at last to a control value and had no significant difference from it 120 minutes after an administration stop. Moreover, we found out the relationship among OAA/S Scale, the BIS value, and the rate of the memory. As a conclusion, the results suggest that recovery of the memory under intravenous sedation with DEX needs 2 hours or more after the administration stop, and OAA/S Scale and the BIS value would be clinical indexes to judge effect and recovery of the amnesia. Therefore, in order to prevent a lapse of memory of notes etc., it is important to explain them in advance, to explain after 2 hours or more passes at BIS value over 81 and checking sufficient recovery, or to show them by a document.

• 2010-04-23

著者

• 村上 加奈

  岩手医科大学歯学部口腔外科学講座歯科麻酔学分野

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