アブストラクト(20巻4号:神奈川歯学)

神奈川歯学

Japanese

Title : 静脈内鎮静法に関する研究 第1報 : フルニトラゼパム静脈内鎮静法の障害者歯科への応用
Subtitle : 原著
Authors : 永井亨, 三宅久実男, 小林裕, 岸本幸郎, 吉田和市, 大沢昭義, 野口政宏, 宮城敦*, 酒井信明*, 檜垣旺夫*
Authors(kana) :
Organization : 神奈川歯科大学麻酔学教室, *神奈川歯科大学小児歯科学教室
Journal : 神奈川歯学
Volume : 20
Number : 4
Page : 449-456
Year/Month : 1986 / 3
Article : 原著
Publisher : 神奈川歯科大学学会
Abstract : 「緒言」静脈内鎮静法は患者の意識や反射を保った状態で, 歯科治療に対する不安感や恐怖心を和らげ, 疼痛に対する感覚を鈍くし, 治療を円滑に行うことを目的としている. 薬剤としては, 緩和精神安定剤やバルビタール剤が単独に, あるいはこれらに鎮痛剤などを併用して使われている. 静脈内鎮静法に現在もっとも広く使用されている薬剤はジアゼパムであり, その安全性は高く, 副作用が少ないことがあげられているが, 欠点として静注時の血管痛や血栓性静脈炎などをおこす危険性がある. 最近登場したフルニトラゼパムはジアゼパムと同じベンゾジアゼピン誘導体であり, その製剤は注射用蒸留水で希釈可能で, しかも血管障害が少ないと言われている. 一方, 障害者の歯科治療は, さまざまの困難性を伴い, その行動管理上の対策として, 抑制治療, 行動変容法, 精神鎮静法, 全身麻酔法などが用いられてきた.
Practice : 歯科学
Keywords :

English

Title : Study on Intravenous Sedation for Dentistrv - Application of Intravenous Sedation with Flunitrazepam to Dental Treatment for Handicapped Patients -
Subtitle : Original article
Authors : Tohru NAGAI, Kumio MIYAKE, Yutaka KOBAYASHI, Yukio KISHIMOTO, Kazuichi YOSHIDA, Akiyoshi OSAWA, Masahiro NOGUCHI, Atsushi MIYAGI*, Nobuaki SAKAI*, Morio HIGAKI*
Authors(kana) :
Organization : Department of Anesthegiology, Kanagawa Dental College, *Department of Pedodontics, Kanagawa Dental College
Journal : Kanagawa Shigaku
Volume : 20
Number : 4
Page : 449-456
Year/Month : 1986 / 3
Article : Original article
Publisher : Kanagawa Odontological Society
Abstract : Flunitrazepam, a benzodiazepine derivative, is prepared for intravenous injection with propylenglycol as same as for diazepam, but this preparation is water soluble. Few angiopathy has been reported with this agent. The authors applied the agent to intravenous sedation for dental procedure in patients with handicapped conditiom. The purpose of this study was to evaluate the effect of flunitrazepam. The subjects were 50 patients with various handicaps(Male 28, female 22), aged 5~54 years, weighed 17.0~73.4kg who had been examined in our Hospital and decided to be indicated to intravenous sedation for dental treatment. Flunitrazepam(2mg/1ml)was diluted to 2mg/5ml with distilled water, injected to a large vein such as the median cubital vein for 30 seconds. The injection was discontinued under careful observation when the patient exhibited optimun sedative signs such as the Verrill's sign, general relaxation etc. The dose was 0.009~0.034mg/kg[mean:0.017+-0.004mg/kg]. Both the systolic and diastolic blood pressures were decreased sightly after the injection, but only the former decrease was significant. After the decrease in blood pressure was restored to normal level, dental treatment was started, and the blood pressure was maintained constant durning the dental procedure, Pulse and respiratory rate were unchanged during sedation, but the latter decreased slightly at the time of discharge. Effect of sedation was evaluated as effective, fairly effective, and not effective both by anesthesiologists and operators separately. Thirty two cases(64.0%)and 30 cases(60.0%)of 50 subjects were judged effective by anesthesiolgists and operators, respectively. Recovery time from injection to discharge took for 113.9+-41.2 minutes. No angiopathy as angialgia and phlebitis was observed in any case. From the results, flunitrazepam was thought to be a useful drug available in dental treaments for the handicapped patients.
Practice : Dentistry
Keywords :