{"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}
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.
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.