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Amaç: Günübirlik anestezi çocuk hastalarda dental girişimlerin uygulanabilirliğini artırmıştır. Bu çalışmadaki amacımız derin sedasyon altında dental tedavi uygulanan çocuk olgularda kullanılan ilaç kombinasyonlarını, güvenilirlik ve etkinlik bakımından karşılaştırmaktır. Gereç ve Yöntemler: Derin sedasyon ile dental tedavi uygulanan ASA I-III, 4-11 yaş arasında 88 çocuk çalışmaya dahil edildi. Kliniğimizin rutin protokolüne göre derin sedasyon uygulanan olguların anestezi formlarında kayıt altına alınan kalp hızı, kan basıncı, oksijen saturasyonu, indüksiyonda kullanılan ajanlar (fentanil, ketamin), total propofol tüketim miktarları, yan etkileri, taburcu edilme zamanları ve ilk oral alım zamanları kaydedilip istatistiksel olarak değerlendirildi. Bulgular: Değerlendirme sonucunda hastaların yaş, cinsiyet, kilo, ASA skorları, ek hastalık varlığı, kilo, anestezi süresi, diş tedavi süresi, dolgu sayısı, çekim sayısı ve lokal anestezi uygulamaları karşılaştırıldığında istatistiksel olarak anlamlı farklılık saptanmadı. Propofol tüketim miktarının, fentanil kullanılan grupta (Grup F),ketamin kullanılan gruba (Grup K) oranla istatistiksel olarak daha fazla olduğu anlamlı olarak tespit edildi (p<0.001). Taburcu olma süresi ketamin kullanılan grupta fentanil kullanılan gruba kıyasla istatistiksel olarak anlamlı şekilde daha uzun bulundu (p<0.001) Ketamin grubunda oral alıma başlangıç süresi fentanil grubuna kıyasla daha geç oldu (p<0.001). Hemodinamik parametreler karşılaştırıldığında Grup K ‘e kıyasla Grup F ‘de daha fazla düşüş izlendi (p<0.05). Oksijen saturasyonu gruplar arası farklılık göstermedi. Sonuç: Dental tedavi için kullanılan her iki anestezi protokolü de güvenilir ve etkindir. Ketamin grubunda daha düşük propofol tüketimi gözlenirken, fentanil grubunda hastaların daha erken taburcu olduğu gözlenmiştir. Sonuç olarak çocuklarda derin sedasyon altında diş tedavisi için her iki kombinasyonun da tercih edilebileceği kanısındayız.
Objective: Daily anesthesia has increased the applicability of dental interventions in children. Our aim in this study was to compare the safety and effectiveness of drug combinations used in childhood dental treatment under deep sedation. Material and Methods: A total of 88 children aged 4-11 years ASA I-III that received deep sedation were included in the study. According to the routine protocol of our clinic, the heart rate, blood pressure, oxygen saturation, induction agents (fentanyl, ketamine), total propofol consumption, side effects, discharge time and first oral intake time were recorded in the anesthesia forms of deep sedation cases and then statistically evaluated. Results: There was no statistically significant difference between the patients' age, sex, weight, ASA scores, presence of additional disease, weight, duration of anesthesia, duration of dental treatment, number of fillings, number of shots and local anesthesia data. The amount of propofol consumed was found to be statistically significantly higher in group F using fentanyl than in group K using ketamine (p <0.001). The time to discharge was longer with ketamine than with fentanyl (p <0.001). Oral intake in the ketamine group was later than the fentanyl group (p <0.001). When haemodynamic parameters were compared, Group F showed more decrease than Group K (p <0.05). Both anesthesia protocols used for dental treatment are reliable and effective. Patients in the fentanyl group were dischargeed earlier and lower propofol consumption was observed in the ketamine group. In conclusion, we believe that both combinations may be used for dental treatment under deep sedation in children.
Objective: Daily anesthesia has increased the applicability of dental interventions in children. Our aim in this study was to compare the safety and efficacy of drug combinations used in childhood dental treatment under deep sedation. Material and Methods: A total of 88 children aged 4-11 years ASA I-III that received deep sedation were included in the study. According to the routine protocol of our clinic, the heart rate, blood pressure, oxygen saturation, induction agents (fentanyl, ketamine), total propofol consumption, side effects, discharge time and first oral intake time were recorded in the anesthesia forms of deep sedation cases and then statistically evaluated. Results: There was no statistically significant difference between the patients’ age, sex, weight, ASA scores, presence of additional disease, weight, duration of anesthesia, duration of dental treatment, number of fillings, number of shots and local anesthesia data. The amount of propofol consumed was found to be statistically significantly higher in group F using fentanyl than in group K using ketamine (p <0.001). The time to discharge was longer with ketamine than with fentanyl (p <0.001). Oral intake in the ketamine group was later than the fentanyl group (p <0.001). When haemodynamic parameters were compared, Group F showed more decrease than Group K (p <0.05). Conclusion: Both anesthesia protocols used for dental treatment are reliable and effective. Patients in the fentanyl group were discharged earlier and lower propofol consumption was observed in the ketamine group. In conclusion, we believe that both combinations may be used for dental treatment under deep sedation in children.
Field : Sağlık Bilimleri
Journal Type : Uluslararası
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