个性化舒适联合麻醉方案对老年门诊口腔手术患者的影响。

IF 1 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL
British journal of hospital medicine Pub Date : 2025-02-25 Epub Date: 2025-02-23 DOI:10.12968/hmed.2024.0778
Chen Cao, Dawei Hu, Jing Cao, Wenjing Zhu, Xiaotong Zhang, Chuxiong Pan
{"title":"个性化舒适联合麻醉方案对老年门诊口腔手术患者的影响。","authors":"Chen Cao, Dawei Hu, Jing Cao, Wenjing Zhu, Xiaotong Zhang, Chuxiong Pan","doi":"10.12968/hmed.2024.0778","DOIUrl":null,"url":null,"abstract":"<p><p><b>Aims/Background</b> Anxiety, fear, and lack of confidence in surgical outcomes can lower the pain threshold of elderly patients. Developing individualized and comfortable anesthesia protocols is critical for optimizing outcomes in elderly patients undergoing oral procedures. This study aimed to investigate the impact of an individualized comfort anesthesia protocol on elderly patients with varying levels of dental anxiety undergoing complex tooth extraction. <b>Methods</b> A retrospective analysis was conducted on 210 elderly patients who underwent complex tooth extractions at the Comfort Oral Treatment VIP Center and Oral Surgery Department of Beijing Stomatological Hospital, Capital Medical University, between December 2022 and May 2024. Patients were categorized into three groups based on Corah's Dental Anxiety Scale: mild dental anxiety (Group G1, 72 cases), moderate dental anxiety (Group G2, 72 cases), and severe dental anxiety (Group G3, 66 cases). Corresponding anesthesia regimens were administered: 0.06 mg/kg, 0.08 mg/kg + 0.03 μg/kg/time, and 0.06 mg/kg + 0.05 μg/kg/time, respectively. Mean arterial pressure (MAP), bispectral index (BIS), and heart rate (HR) were measured at sedation onset (T1), after local anesthesia injection (T2), and at the end of tooth extraction (T3). Sedation onset time, recovery time, discharge time, and adverse reactions were also recorded. <b>Results</b> Repeated measures analysis of variance (ANOVA) revealed significant difference in BIS within groups over time (<i>p</i> < 0.001), with notable group-by-time interactions (<i>p</i> < 0.001) and significant within-group effects (<i>p</i> < 0.001). For MAP, there was a significant within-group effect (<i>p</i> < 0.001) and group-by-time effect (<i>p</i> < 0.001), while the time effect was not statistically significant (<i>p</i> = 0.302). HR demonstrated a significant within-group effect (<i>p</i> < 0.001) but no significant time effects (<i>p</i> = 0.278) and marginally non-significant group-by-time interactions (<i>p</i> = 0.052). Compared with Group G3, Groups G1 and G2 exhibited shorter sedation onset, recovery times, and discharge times (<i>p</i> < 0.001). Additionally, Group G3 had longer sedation onset and recovery times compared to Group G2 (<i>p</i> < 0.001). No significant difference in discharge times was observed between Groups G1 and G2 (<i>p</i> > 0.05). Among the adverse reactions, bradycardia and drowsiness were significantly more frequent in specific groups (<i>p</i> < 0.05). <b>Conclusion</b> An individualized comfort-based anesthesia protocol tailored to the levels of anxiety, fear, and anticipated pain effectively provides optimal sedative and anesthetic outcomes for elderly patients undergoing complex tooth extractions in outpatient settings. This approach exhibits significant benefits in sedation onset, recovery, and discharge times while minimizing adverse reactions, making it a practical and effective option for clinical application.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 2","pages":"1-14"},"PeriodicalIF":1.0000,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of Individualized Comfort-Based Combined Anesthesia Protocol on Elderly Patients Undergoing Outpatient Oral Procedures.\",\"authors\":\"Chen Cao, Dawei Hu, Jing Cao, Wenjing Zhu, Xiaotong Zhang, Chuxiong Pan\",\"doi\":\"10.12968/hmed.2024.0778\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Aims/Background</b> Anxiety, fear, and lack of confidence in surgical outcomes can lower the pain threshold of elderly patients. Developing individualized and comfortable anesthesia protocols is critical for optimizing outcomes in elderly patients undergoing oral procedures. This study aimed to investigate the impact of an individualized comfort anesthesia protocol on elderly patients with varying levels of dental anxiety undergoing complex tooth extraction. <b>Methods</b> A retrospective analysis was conducted on 210 elderly patients who underwent complex tooth extractions at the Comfort Oral Treatment VIP Center and Oral Surgery Department of Beijing Stomatological Hospital, Capital Medical University, between December 2022 and May 2024. Patients were categorized into three groups based on Corah's Dental Anxiety Scale: mild dental anxiety (Group G1, 72 cases), moderate dental anxiety (Group G2, 72 cases), and severe dental anxiety (Group G3, 66 cases). Corresponding anesthesia regimens were administered: 0.06 mg/kg, 0.08 mg/kg + 0.03 μg/kg/time, and 0.06 mg/kg + 0.05 μg/kg/time, respectively. Mean arterial pressure (MAP), bispectral index (BIS), and heart rate (HR) were measured at sedation onset (T1), after local anesthesia injection (T2), and at the end of tooth extraction (T3). Sedation onset time, recovery time, discharge time, and adverse reactions were also recorded. <b>Results</b> Repeated measures analysis of variance (ANOVA) revealed significant difference in BIS within groups over time (<i>p</i> < 0.001), with notable group-by-time interactions (<i>p</i> < 0.001) and significant within-group effects (<i>p</i> < 0.001). For MAP, there was a significant within-group effect (<i>p</i> < 0.001) and group-by-time effect (<i>p</i> < 0.001), while the time effect was not statistically significant (<i>p</i> = 0.302). HR demonstrated a significant within-group effect (<i>p</i> < 0.001) but no significant time effects (<i>p</i> = 0.278) and marginally non-significant group-by-time interactions (<i>p</i> = 0.052). Compared with Group G3, Groups G1 and G2 exhibited shorter sedation onset, recovery times, and discharge times (<i>p</i> < 0.001). Additionally, Group G3 had longer sedation onset and recovery times compared to Group G2 (<i>p</i> < 0.001). No significant difference in discharge times was observed between Groups G1 and G2 (<i>p</i> > 0.05). Among the adverse reactions, bradycardia and drowsiness were significantly more frequent in specific groups (<i>p</i> < 0.05). <b>Conclusion</b> An individualized comfort-based anesthesia protocol tailored to the levels of anxiety, fear, and anticipated pain effectively provides optimal sedative and anesthetic outcomes for elderly patients undergoing complex tooth extractions in outpatient settings. This approach exhibits significant benefits in sedation onset, recovery, and discharge times while minimizing adverse reactions, making it a practical and effective option for clinical application.</p>\",\"PeriodicalId\":9256,\"journal\":{\"name\":\"British journal of hospital medicine\",\"volume\":\"86 2\",\"pages\":\"1-14\"},\"PeriodicalIF\":1.0000,\"publicationDate\":\"2025-02-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"British journal of hospital medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.12968/hmed.2024.0778\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/2/23 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"British journal of hospital medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.12968/hmed.2024.0778","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/23 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0

摘要

目的/背景焦虑、恐惧和对手术结果缺乏信心可以降低老年患者的疼痛阈值。制定个性化和舒适的麻醉方案对于优化老年患者接受口腔手术的结果至关重要。本研究旨在探讨个性化舒适麻醉方案对复杂拔牙过程中不同程度牙齿焦虑的老年患者的影响。方法回顾性分析2022年12月至2024年5月在首都医科大学附属北京口腔医院舒适口腔治疗VIP中心及口腔外科接受复杂拔牙治疗的210例老年患者。根据Corah牙病焦虑量表将患者分为轻度牙病焦虑组(G1组,72例)、中度牙病焦虑组(G2组,72例)、重度牙病焦虑组(G3组,66例)。给予相应的麻醉方案:0.06 mg/kg、0.08 mg/kg + 0.03 μg/kg/次、0.06 mg/kg + 0.05 μg/kg/次。测定镇静开始(T1)、局麻注射后(T2)和拔牙结束(T3)时的平均动脉压(MAP)、双谱指数(BIS)和心率(HR)。记录镇静起效时间、恢复时间、出院时间及不良反应。结果重复测量方差分析(ANOVA)显示各组间BIS随时间的差异显著(p < 0.001),组间相互作用显著(p < 0.001),组内效应显著(p < 0.001)。MAP组内效应显著(p < 0.001),分组时间效应显著(p < 0.001),时间效应无统计学意义(p = 0.302)。HR表现出显著的组内效应(p < 0.001),但没有显著的时间效应(p = 0.278),组间时间相互作用不显著(p = 0.052)。与G3组相比,G1和G2组镇静起效时间、恢复时间和出院时间均较短(p < 0.001)。此外,与G2组相比,G3组镇静起效时间和恢复时间更长(p < 0.001)。G1组与G2组患者出院时间差异无统计学意义(p < 0.05)。不良反应中,特定组的心动过缓、嗜睡发生率显著高于对照组(p < 0.05)。结论针对焦虑、恐惧和预期疼痛水平量身定制的个性化舒适麻醉方案有效地为门诊进行复杂拔牙的老年患者提供了最佳的镇静和麻醉效果。这种方法在镇静起效、恢复和出院时间上有显著的好处,同时最大限度地减少不良反应,使其成为临床应用的一种实用有效的选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of Individualized Comfort-Based Combined Anesthesia Protocol on Elderly Patients Undergoing Outpatient Oral Procedures.

Aims/Background Anxiety, fear, and lack of confidence in surgical outcomes can lower the pain threshold of elderly patients. Developing individualized and comfortable anesthesia protocols is critical for optimizing outcomes in elderly patients undergoing oral procedures. This study aimed to investigate the impact of an individualized comfort anesthesia protocol on elderly patients with varying levels of dental anxiety undergoing complex tooth extraction. Methods A retrospective analysis was conducted on 210 elderly patients who underwent complex tooth extractions at the Comfort Oral Treatment VIP Center and Oral Surgery Department of Beijing Stomatological Hospital, Capital Medical University, between December 2022 and May 2024. Patients were categorized into three groups based on Corah's Dental Anxiety Scale: mild dental anxiety (Group G1, 72 cases), moderate dental anxiety (Group G2, 72 cases), and severe dental anxiety (Group G3, 66 cases). Corresponding anesthesia regimens were administered: 0.06 mg/kg, 0.08 mg/kg + 0.03 μg/kg/time, and 0.06 mg/kg + 0.05 μg/kg/time, respectively. Mean arterial pressure (MAP), bispectral index (BIS), and heart rate (HR) were measured at sedation onset (T1), after local anesthesia injection (T2), and at the end of tooth extraction (T3). Sedation onset time, recovery time, discharge time, and adverse reactions were also recorded. Results Repeated measures analysis of variance (ANOVA) revealed significant difference in BIS within groups over time (p < 0.001), with notable group-by-time interactions (p < 0.001) and significant within-group effects (p < 0.001). For MAP, there was a significant within-group effect (p < 0.001) and group-by-time effect (p < 0.001), while the time effect was not statistically significant (p = 0.302). HR demonstrated a significant within-group effect (p < 0.001) but no significant time effects (p = 0.278) and marginally non-significant group-by-time interactions (p = 0.052). Compared with Group G3, Groups G1 and G2 exhibited shorter sedation onset, recovery times, and discharge times (p < 0.001). Additionally, Group G3 had longer sedation onset and recovery times compared to Group G2 (p < 0.001). No significant difference in discharge times was observed between Groups G1 and G2 (p > 0.05). Among the adverse reactions, bradycardia and drowsiness were significantly more frequent in specific groups (p < 0.05). Conclusion An individualized comfort-based anesthesia protocol tailored to the levels of anxiety, fear, and anticipated pain effectively provides optimal sedative and anesthetic outcomes for elderly patients undergoing complex tooth extractions in outpatient settings. This approach exhibits significant benefits in sedation onset, recovery, and discharge times while minimizing adverse reactions, making it a practical and effective option for clinical application.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
British journal of hospital medicine
British journal of hospital medicine 医学-医学:内科
CiteScore
1.50
自引率
0.00%
发文量
176
审稿时长
4-8 weeks
期刊介绍: British Journal of Hospital Medicine was established in 1966, and is still true to its origins: a monthly, peer-reviewed, multidisciplinary review journal for hospital doctors and doctors in training. The journal publishes an authoritative mix of clinical reviews, education and training updates, quality improvement projects and case reports, and book reviews from recognized leaders in the profession. The Core Training for Doctors section provides clinical information in an easily accessible format for doctors in training. British Journal of Hospital Medicine is an invaluable resource for hospital doctors at all stages of their career. The journal is indexed on Medline, CINAHL, the Sociedad Iberoamericana de Información Científica and Scopus.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信