静脈麻酔下における歯科処理時のプロポフォール投与量の増加要因 [in Japanese] Factor of increased propofol dosage during dental treatment under intravenous anesthesia. [in Japanese]
Access this Article
Search this Article
Introduction Dental treatment using propofol (trade name Diprivan) was carried out for people with disabilities who have difficulties with dental treatment so that dental treatment could be carried out safely and smoothly. This time, we investigated for the purpose of clarifying the factors of those who need 3.5 µg/ml or more when sedated with propofol. Object and method Methods The subjects were 34 persons, who required the intravenous anesthesia method at the time of dental treatment, among patients who visited Matsumoto Dental University Hos-pital special specialist department from May 1st to September 30 th , 2015. Gender, age, presence or absence of regular medications were noted, weight and height were measured, and BMI was calculated. Disease, treatment, type of disability, and intellectual level from the medical record were entered on the survey form. As an evaluation of adaptability to dental treatment, they were classified into 4 stages: "Can sit on the medical table"; "Can sleep the treatment table"; "Can do an oral examination"; and "Can do PTC". The diffuser TCI function was used to initiate intravenous administration at the target blood concentration of 3.0 µg/ml. Dental treatment was started with blood concentration in the brain when the opening device was smoothly inserted. If this target was not possible, 0.2 µg/ml each was listed. Blood concentrations and intracerebral concentrations of propofol during treatment were recorded. The intracerebral concentration where the opening device was smoothly inserted, the lowest brain concentration and the maximum brain concentration at the time of treatment were also recorded.Result 34 subjects (28 males, 6 females) had an average age of 37.6±12.4 years. The items asso- ciated with brain concentration of propofol were subjects aged 50 years or older (P = 0.01), BMI (P = 0.15), dental phobia (P = 0.001), and autistic spectrum disease (P = 0.07). The factor that required propofol brain concentration of over 3.5 µg/ml was dental phobia (odds ratio: 28.5: confidence interval 1.₉–421) by the logistic regression analysis. Conclusion A factor that requires propofol of 3.5 µg/ml or more at the time of dental treatment, for those who can assume a supine position without making refusing actions at the medical table, was dental phobia. There was no relevance to the content of treatment or to the adaptability to dental treatment.
- 松本歯学 = Journal of the Matsumoto Dental University Society
松本歯学 = Journal of the Matsumoto Dental University Society 44(1), 1-6, 2018-06-29