소아환자의 진정요법 효과와 그와 연관된 변수에 대한 연구 = A study on the efffects of sedation and related variables for pediatric dental patients

국문 초록 (Abstract)

소아치과에서 진정요법은 chloral hydrate와 hydroxyzine을 함께 경구투여하는 방법이 가장 보편적이고, 진정의 심도가 술자가 원하는 정도에 미치지 못할 때에는 midazolam이나 N_(2)O/O_(2)를 병용투여하는 경우가 종종 있다.
본 연구는 chloral hydrate와 hydroxyzine을 이용한 진정요법의 효과와 안전성을 평가하고, 경구투여만으로 적절한 진정 수준을 얻지 못하여 N_(2)O/O_(2)를 병용투여한 경우, N_(2)O/O_(2)의 치료시간과 부작용에 대한 영향 그리고, 진정요법 효과에 영향을 줄 수 있는 변수들(연령, 성별, 체중, patient compliance, waiting time 등)을 확인할 목적으로 시행하였다.
2004년 12월부터 2005년 9월까지 단국대학교 치과병원 소아치과에서 chloral hydrate와 hydroxyzine을 이용하여 진정요법하에 치료받은 평균연령 30±8개월(12-51개월), 체중 13±2kg(9.5-18kg)의 총 94명(남아-46명, 여아-48명)의 환아들을 대상으로 조사하였다.
진정요법의 효과, 체중, 연령, 병용투여 방법에 따라 군을 분류하여 성별, 연령, 체중, patient compliance, waiting time, 치료시간, 치료양(RBVU), 부작용 등을 평가하였다.
진정요법 성공률은 85%였다. 진정요법에 성공한 그룹이 실패한 그룹보다 N_(2)O/O_(2)로 수면을 유도하여 사용하는 경우가 많았고, 치료시간이 길었다. 36개월, 14kg미만인 환아는 경구투여만으로 수면에 이를 수 있었고, waiting time이 짧았다. 36개월 이상인 환아는 N_(2)O/O_(2)를 사용하여 수면을 유도하는 경우가 많았다.
연령과 N_(2)O/O_(2)사용시간, N_(2)O/O_(2)사용과 치료시간사이에는 상관관계가 존재한 반면, 체중과 N_(2)O/O_(2)사용시간사이에는 상관관계가 없었다.
치료시간 연장, N_(2)O/O_(2) 사용여부와 부작용 발생간에서는 통계학적으로 유의한 차이는 확인되지 않았다.

다국어 초록 (Multilingual Abstract)

The combination of chloral hydrate and hydroxyzine is one of the safest and most commonly used drug regimens for sedating young, uncooperative pediatric dental patients. Midazolam IM or IN and N_(2)O/O_(2) inhalation is sometimes administered with chloral hydrate and hydroxyzinecombination when deeper and longer sedation is needed.
The purpose of this study was to assess the outcome and safety of chloral hydrate, hydroxyzine and N_(2)O/O_(2) in the sedation of a large number of uncooperative pediatric dental patients and to identify variables associated with their effectiveness.
In a nine-month retrospective study, 171 records of sedation performed in 94 healthy children(male 46, female 48) with mean age of 30±8 months were reviewed. The authors analyzed several variables such as age, sex, weight, methods of drug delivery, waiting time after drug delivery, treatment rendered, treatment time, adverse events, sedation outcome.
Eighty five percent of sedation had success behavioral outcome. Sedation sessions rated success used more N_(2)O/O_(2) administration and had longer treatment duration than sedation sessions rated failure.
A children patient under 36 months of age had enough sleep by on1y oral administration and the mean waiting time of this case was significantly shorter than that of a children patient over 36 months of age.
There was a clear correlation between age and N_(2)O/O_(2) using time, but no correlation between weight and N_(2)O/O_(2) using time.
There was no statistically significant difference among variables of treatment duration, N_(2)O/O_(2) administration and adverse event.

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