全身麻醉下的牙科治療

General Anesthesia in Dental Treatment

陳弘森(Homg-Sen Chen) ； 蕭思郁(Szu-Yu Hsiao) ； 康銘原(Ming-Yuan Kang) ； 黃純德(Shu-Te-Huang)

《臺灣口腔醫學會雜誌》 15卷1期 (1999/06) Pp. 177-185

摘要

本研究以高醫殘智障者牙科門診的患者為樣本,探討全身麻醉下患者的特質,以做為牙科醫療的參考。樣本數共135人,其結果 如下: (1)患者的年齡以5歲以下小孩為最多(36.3%)其次為6 ~lO歲 (25.2%) ; 11~15最(11.9%); 16~20歲(8.1%) ;21-25歲(8.9%) ; 26歲以上(9 .6%) ;若以10歲以下小孩來算,則佔了61. 5%,超過半數以上,整體而言,男性多於女 性。 (2)接受全身麻醉的原因分析：以不合作患者為第一位(40.7%) ,其次為精神障礙者 (26 . 7%) ;腦性痲痺者(17 .0%) ;情緒障礙者(8 . 2%) ;其他因素者(3.7%) 癲癇症者( 2 . 2%);多重殘障者(1 . 5% )。 若扣除不合作患者及其他因素患者,則剩下的都是身心不自由者(55.6%) ,超過半數以上。 (3)麻醉的時間：30分鐘以內(3.0%) ;31分鐘-60分鐘(14.1%) ; 61分鐘 90分鐘(20.0%);91分鐘~120分鐘(25.2%) i 121分 鐘~150分鐘(22.2%) ; 151分鐘以上(15.5%)。其中61~150分鐘者佔了67 .4% '達到軌以上。60分鐘以內 (17.1%) ,和151分鐘以上(15.5%)所佔之比例最小。 (4)併發症：以日惡心及嘔吐(64.4%)為最常見,其次為術後疼痛 (17.8%) ,其他症狀(11.1%) ,延遲恢復( 6 . 7%) ,病例中未見有過敏反應或死亡病例。 門診全身麻醉可望成為21世紀中,一種安全、高效率、高品質的整體牙醫療之利器。

關鍵字

全身麻醉 ； 殘智障者

並列摘要

The restrospective study describes characteristics of 135 outpatients in a Handicapped Dental Clinic of Kaohsiung Medical College Hospital during the period from December 1997 to Jaunary 1999. Information collected on the outpatients included sex, age, address, initial diagnosis etc.. The concluslons are as followed: (1) Comparing the age distribution, under age 5 years old occupies 36.3% of total patients, while 25.2% in 6-10 years; 11.9% in the 11-15 years; 8 - 1 % in 16-20 years; 8.9% in 21-25 years and 9.6% over 26 years old. The under 10 years old children made up the largest group (61.5%). The overall male patients were higher than that of the female patients. This study shows that most patients treated using general anesthesia were children. (2) As to the reason for general anesthesia, uncooperativeness comprised majority of total - tion was 26.7%, cerebral palsy was 17.0% ; emotional disturbance was 8.2% ; miscellaneous cases was 3.7% ; epilepsy was 2.2°10 ; multihandicapped was 1.5% only. More than one half the patients received dental treatment using general anesthesia because of disablement (55.6%). (3) The duration of general anesthesia varied from 30 minutes to 3 hours following the time of dental procedure. Most of the cases were done by intravenous general anesthesia. Only 6 cases were performed by endotracheal intubation. (4) The most frequent complications was nausea with vomiting (64.4%), other complications ineluded postoperative pain (17.8%) ; miseellanea cases (11.1%) ; delayed recovery (6.7%) in patient. There were no allergy or deaths. This type of anesthesia resulted in an acceptability of complications in our analysis.

並列關鍵字

general anesthesia ； handicap