Esra ÇAĞIRAN, Can EYİGÖR, CANDAN EFEOĞLU, Taner BALCIOĞLU, Meltem UYAR

Diş çekimi uygulamalarında sedasyon deneyimlerimiz

Amaç: Çalışmamızın amacı, sedasyon altında diş çekimi yapılan hastalarda anestezi yöntemimizi retrospektif olarak bildirmektir. Yöntem: 2005-2009 yılları arasında sedasyon altında diş tedavisi yapılan hastaların tıbbi kayıtları tarandı. Hastalar, 0,75 mg kg-1 midazolam + 5 mg kg-1 ketamin peroral (PO) verilen (Uygulama 1), PO uygulama ile yeterli sedasyonun sağlandığı hastalarda lokal anestezi uygulaması sırasında reaksiyon gösteren hastalara ek olarak 2 mg kg-1 ketamin + 10 µg kg-1 atropin intramuskuler (iM) verilen (Uygulama 2), PO ajan içmeyen % 60 O2 + % 40 N2O karışımı içinde % 1 sevofluran yüz maskesi uygulanan (Uygulama 3), sedasyon ile diş tedavisi yapılamayan genel anestezi randevusu verilen (Uygulama 4) olarak gruplandırıldı. Ayrıca hastalar Grup S: sağlıklı, Grup MR: mental retarde olarak iki gruba ayrılarak karşılaştırıldı. işlem sonrasında oluşan komplikasyonlar kaydedildi. Bulgular: Toplam 334 (Grup S: 305, Grup MR: 29) hasta değerlendirmeye alındı. Uygulama 1-4 sayıları (%) sırasıyla 249 (% 74,6), 55 (% 16,5), 24 (% 7,2), 6 (% 1,8) olarak saptandı. Grup S hastalarının, yaşı Grup MR hastalara göre istatistiksel olarak anlamlı daha küçüktü (p

Our experience in tooth extraction under sedation

Aim: The aim of this study is to report our method of anesthesia retrospectively in patients who were scheduled for tooth extraction under sedation. Methods: Medical records of patients who received dental treatments under sedation between 2005-2009 were evaluated. The patients were divided into four groups: 0.75 mg kg-1 midazolam + 5 mg kg-1 peroral (PO) ketamine administered group (Application 1); additional 2 mg kg-1 ketamine + 10 µg kg-1 atropine intramuscular (IM) administered group where, despite achieving satisfactory sedation with PO, patients had shown reaction to local anesthesia (Application 2); the group which did not receive any PO agents were administered 1 % sevoflurane within a mixture of 60 % O2 + 40 % N2O with a facial mask (Application 3); group scheduled for general anesthesia for whom dental treatment could not be performed under sedation (Application 4). In addition, the patients were divided into two groups, namely Group H: healthy and Group MR: mentally retarded that were compared. Post-operative complications were recorded on patients’ notes. Results: A total of 334 patients (Group H: 305, Group MR: 29) were evaluated. Number of applications 1-4 (%) were determined as 249 (74.6 %), 55 (16.5 %), 24 (7.2 %) and 6 (1.8 %), respectively. Ages of the patients in Group H were significantly lower than patients in Group MR (p<0.0001). Rate of successful tooth extraction under sedation was significantly higher in Group H (p<0.0001). Thirty patients experienced nausea and vomiting (9 %) post-operatively. Conclusion: We believe that reliable dental treatments can be provided through a multidisciplinary collaboration involving the anesthetist and the dentist, providing appropriate sedation methods and appropriate patients are chosen.

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