以微電腦牙科麻醉系統對兒童患者施打下顎齒槽骨神經麻醉的疼痛程度之評估研究

Pain Assessment of the Pediatric Patients Receiving Mandibular Block Anesthesia Using a Computerized Anesthetic System (The Wand)

陳亮如(Liang-Ru Chen) ； 劉正芬(Jeng-Fen Liu)

《臺灣兒童牙醫學雜誌》 6卷1期 (2006/03) Pp. 189-195

https://doi.org/10.6319/TJPD.2006.6(1).2

摘要

目的：比較微電腦牙科麻醉系統和傳統牙科注射麻醉，應用於兒童牙科患者時，在麻醉注射的疼痛成方面是否有差異存在。
材料與方法：四至十二歲孩童依學齡分組，採「分口設計」進行，一側以微電腦牙科麻醉系統（實驗組），另一側以傳統牙科注射麻醉（對照組）進行下顎齒槽神經麻醉。評估部分包括：主觀的孩童自我疼痛評估（臉譜圖）、客觀的合作程度評估（賀氏表）、心跳速率的變化、及操作時間。以成對t值測驗(paired t test)統計方式來評估結果。
結果：在學齡前學童中，實驗組和對照組在孩童自我疼痛評估及心跳速率的變化上並無統計上顯著的差異；但在合作程度評估中，實驗組部份顯示了較明顯的不合作行為，且有統計上顯著的差異。在學齡學童中，無論是在孩童自我疼痛評估、合作程度評估及心跳速率的變化上，實驗組和對照組的數值皆無統計上顯著的差異。微電腦牙科麻醉系統操作平均時間為170秒，顯著高於傳統牙科注射麻醉（80秒）。
結論：微電腦牙科麻醉系統和傳統牙科注射麻醉，應用於兒童牙科患者時，兩者在注射時疼痛程度的比較上，並無統計上顯著的差異。但前者需較長的操作時間，對於學齡前孩童較不合適，因行為配合程度較差。

關鍵字

阻斷麻醉 ； 微電腦輔助系統 ； 疼痛評估

並列摘要

Aim: The purpose of this study was to compare the pain perception of inferior alveolar nerve block using the Wand and conventional anesthetic syringe infiltration anesthesia.
Materials and Methods: Subjects consisted of 35 patients aged 4 to 12 years requiring bilateral inferior alveolar nerve block in the dental procedure. Split mouth design was used and the patient served as their own control. Pain rating was assessed subjectively by modified face scale and objectively by heart rate change. Pain behavior was observed and rated by modified Houpt scale. Paired sample t test was used for statistical analysis.
Results: In the preschool children group (16 patients, mean age: 4 year 11 months), no significant difference regarding the face scale and heart rate were observed in both methods; however, the preschool children displayed significantly better behavior than conventional infiltration anesthesia. In the school children group, no significant differences were observed in both methods regarding pain assessment and behavior rating. Mean operative time was 171 seconds using the Wand method and 79 seconds in the conventional infiltration method, which showed significant difference.
Conclusion: There was no significant difference of pain rating between the computerized local anesthetic system (the Wand) and the conventional local anesthetic infiltration anesthesia. There were significantly more disruptive behaviors in the preschool children group using the Wand.

並列關鍵字

Nerve Block Anesthetics ； Computer Assisted Instrumentation ； Pain Measurement