E ÇAĞIRAN, B. SEZER, B. KOYUNCU, T. GÜNBAY

Diş hekimliğinde implant cerrahisinde intravenöz midazolam etkinliği

Amaç: Diş hekimliğinde implant cerrahisinde işlem süresinin uzunluğu hastanın toleransını azaltmakta ve cerrahın çalışma şartlarını zorlaştırabilmektedir. Bu çalışmanın amacı, diş hekimliğinde lokal anestezi altında implant cerrahisi yapılan hastalarda intravenöz (IV) midazolam ile bilinçli sedasyon uygulamasının hemodinamik ve hasta-hekim memnuniyeti üzerine etkilerinin araştırılmasıdır. Gereç ve Yöntem: Lokal anestezi altında implant cerrahisi yapılan ASA I-II 20 hastanın verileri retrospektif olarak değerlendirildi. Hastalardan operasyon öncesi dental anksiyeteyi ölçen Corah Dental Anksiyete Skalasını (DAS) yanıtlamaları istendi. Hastaların periferik oksijen saturasyonu (SpO2) ve kalp atım hızı (KAH) moniterize edildi ve 5 dakikada bir kaydedildi. Dosya taraması IV 0.05 mg/kg midazolam+lokal anestezi verilen hastalar Grup I (n=10), yalnız lokal anestezi uygulanan hastalar Grup II (n=10) olarak adlandırıldı. Operasyondan sonra hasta-hekim memnuniyeti 1=kötü, 2=orta, 3=iyi, 4=mükemmel skalası ile değerlendirildi. Bulgular: Gruplar yaş, cinsiyet, ağırlık, operasyon öncesi DAS ve operasyon süresi açısından benzerdi. KAH için grup içi ölçümlerde istatistiksel olarak anlamlı farklılık bulunmadı (p>0.05). SpO2 için grup içi ölçümlerde ise Grup Ide zaman içinde istatistiksel anlamlı düşme gözlenirken (p=0.014), Grup II'de istatistiksel olarak anlamlı fark gözlenmedi (p>0.05). Sonuç: Bilinçli sedasyon uygulanan hastalarda zaman içinde SpO2 değerinde azalma olmasının dışında, iki grup arasında fark bulunmadı.

Efficacy of intravenous midazolam in dental implant surgery

Aim: The long-lasting procedure in dental implant surgery may impair a patients tolerance and make the working conditions for the surgeon difficult. The aim of this study was to explore the effect of administering conscious sedation with intravenous (IV) midazolam to patients undergoing dental implant surgery under local anesthesia on the basis of hemodynamics and patient-doctor satisfaction. Materials and Methods: The data from 20 patients of ASA I-II whose implant surgery were carried out under local anesthesia have been evaluated retrospectively. Before the operations, the patients were asked to respond to the Corah Dental Anxiety Scale (DAS) which measures dental anxiety. The peripheral oxygen saturation (SpO2) and heart rates (HR) of the patients were monitored and recorded every 5 minutes. The patients who were administered IV midazolam 0.05 mg/kg+local anesthesia were named as Group I (n=10) and those who were administered only local anesthesia as Group II (n=10). Patient-doctor satisfaction was assessed after the operation on a scale of 1=poor, 2=moderate, 3=good and 4=superior. Results: The groups were similar in terms of age, gender, weight, preoperative DAS and length of operation. No statistically significant difference was found in intra-group HR measurements (p>0.05). In intra-group SpO2 measurements, on the other hand, there was a statistically significant decrease over time in Group I (p=0.014), but there was no statistically significant difference in Group II (p>0.05). Conclusion: In conclusion, beside the fact that there was a decline of SpO 2 levels in patients who were administered conscious sedation, there was no statistical difference between the two groups.

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