• Journal of the korean academy of Pediatric Dentistry
• /
• v.26 no.4
• /
• pp.579-588
• /
• 1999

Monitoring of patients is essential in assuring the safety of sedation in the dental office. The purpose of this study was to explore the utilization and preferences of sedation, utilization of monitoring methods, and the preparation for emergencies during sedation. Members of the Korean Academy of Pediatric Dentistry were surveyed(n=245) from 1998. 10. 1 to 1998. 12. 20 to establish current trends in the use of sedation practices and monitoring methods in Korea. Findings of the survey include: 1. Twenty nine percent of pediatric dentists use sedative agents in their practices. Seventy one percent of pediatric dentists do not use any sedative agents in their practices 2. Thirty nine percent of pediatric dentists who use sedative agents do so without monitoring devices 3. Nitrous oxide inhalation sedation was the most frequently utilized sedation method by pediatric dentists and chloral hydrate was the most frequently utilized sedative by pediatric dentists. Pulse oximeter was the most frequently utilized monitoring method during sedation in dental office. 4. Only twenty eight percent of pediatric dentists obtain the informed consent of the child's legal guardian. 5. Only sixty percent of pediatric dentists prepare for emergencies during sedation.

• The Journal of the Korean dental association
• /
• v.47 no.11
• /
• pp.736-749
• /
• 2009

근래 환자의 불안을 조절하는 것이 성공적인 치료에 매우 중요하다는 인식이 확산되면서 의과, 치과, 영상의학과, 응급실 및 외래 수술센터 등에서 진정요법에 대한 필요가 현저하게 늘어났다. 응급상황이거나 아니거나 진정요법의 필요성은 점차 증가하고 있고 대한 소아치과학회는 이러한 진정요법에 대한 지침을 출간한 바 있다. 이번 개정은 진정요법에 필요한 적절한 환자감시(monitoring)의 필요에 관한 최신지견을 반영한 것이나 그럼에도 불구하고 이 지침에 충실하였다고 해서 특정환자의 결과를 보장하지는 못한다. 그러 나 이번에 소개하는 진정요법 protocol은 널리 받아들여지는 것으로 부작용 역시 최소화한 것이다. 소아 환자의 진정요법은 원하는 수준의 진정이나 투여 방법과는 상관없이 호흡기능 저하와 환자의 방어 반응이 소실될 수도 있다는 인식하에 작성되었다. 이번 호에서는 최근 2006년에 미국소아과학회와 미국소아치과학회가 공동으로 개정된 지침(Guideline for Monitoring and Management of Pediatric Patients During and After Sedation for Diagnostic and Therapeutic Procedures developed and endorsed by AAP a and AAPD)이 어떻게 변경되는지에 중점적으로 알아보며 새로 변경된 지침에 따라 소아치과의의 진정요 법의 진료와 교육도 영향을 미칠 것이다. 이러한 영향으로 다양한 약 투여방법(Alternative routes of d drug administration)과 다양한 약물의 선택에 대해 알아 보기로 한다.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.32 no.3
• /
• pp.444-453
• /
• 2005

Sometimes the dentists encounter a child who can not be treated with traditional behavior management techniques (for example, reward, restraint, Tell-Show-Do, familialization). In such a case, the dentists use sedation technique. Recently, in Korea, the use of sedation by pediatric dentists is increased. But, the guideline and survey of sedation is very insufficient. Now, we need a survey of sedation practice in Korea. We carried out research on the actual condition about sedation with a questionaire to pediatric dentists in Korea. Followings are the conclusions 1. Sixty six percent of pediatric dentists use sedative agents in their practice. In this study, using sedation shows an increase as compared with the past. 2. Determinative factors of using sedation were orderly behavior management, number of visiting, guidian's opinion, amount of treatment, general condition. 3. Distribution of ages in patients sedated with agents was orderly 3 years, 4-5 years, under 2 years, 6-10 years, more than 10 years. 4. Particular sedative drugs were chloral hydrate 60-70mg/kg, hydroxyzine 10-40mg/kg(25mg/kg), and oral route was the most favorable route. 5. Observation of skin and nail color, pulse oximeter were the most frequently utillized monitoring method during sedation. 6. Only fifty six percent of pediatric dentists complete the cardiopulmonary resuscitation course.

• Journal of the Korea Convergence Society
• /
• v.12 no.12
• /
• pp.573-581
• /
• 2021

This study aims to investigate the awareness, nursing needs, and nursing satisfaction of conscious sedation, and their relationships in the guardians of hospitalized children receiving conscious sedation. Data were collected from 120 guardians of children who were admitted to the pediatric ward of University Hospital C in D city from July 6 to October 6, 2016 and received conscious sedation as a pretreatment for diagnostic tests. The result showed that the guardians' awareness was relatively low (2.49±0.83) and nursing needs (4.53±0.40) was found to be significantly higher than nursing satisfaction (3.81±0.56)(p<.001). Awareness showed a significant positive correlation with nursing satisfaction (r=.18, p=.048) and there was a significant positive correlation between nursing needs and satisfaction (r=.20, p=.033). This result suggested that in order to improve the nursing satisfaction of the guardians, it is necessary to understand the awareness and nursing needs of the guardians on conscious sedation. In addition, the development of customized nursing intervention should be carried out based on the awareness and nursing needs.

• Journal of The Korean Dental Society of Anesthesiology
• /
• v.7 no.1
• /
• pp.13-17
• /
• 2007

At Sedation Clinic of Department of Dentistry in Hanyang University Medical Center, total 92 dental treatments under intravenous conscious sedation using midazolam alone for 80 patients were carried out from March 2006 to February 2007. Following the previous article concerning our sedation protocol, the retrospective analyses of our cases were presented in detail. By the evidence-based approach, we hope that our study will help the general dental practitioners perform the intravenous conscious sedation using midazolam alone safely and effectively.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.33 no.1
• /
• pp.62-69
• /
• 2006

Objective : This study was conducted to investigate as to whether obesity have any effects on conscious sedation outcomes. Methods : Forty children (mean age 30.5 months, mean height and weight were 91.3cm, 14.3kg respectively) were sedated with chloral hydrate (60 mg/kg) and hydroxyzine (25mg). The relative obesity rate of the patients was obtained by the proportion of height to weight and the tonsil size of the patients was classified by Brodsky's scale. The overall sedation outcomes were evaluated by Houpt's scale. The pulse and respiratory rates during sedation were also evaluated. Results: The obesity of the patients had no statistically significant effects on movement, crying during sedation. However, an increase in obesity had negative effects on the overall conscious sedation outcomes. Conclusion: This investigation demonstrated that increased obesity may cause detrimental effects on pediatric conscious sedation outcomes.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.28 no.3
• /
• pp.337-344
• /
• 2001

The combination of chloral hydrate and hydroxyzine is one of the safest and most commonly used drug regimens for sedating young, uncooperative pediatric dental patients. The continuous monitoring of respiratory function and early recognition of respiratory difficulties are essential for the successful management of sedated dental patients. The purpose of this study was to evaluate the success rate of the sedation and the hypoxia through monitoring the oxygen desaturation in the pulse oximeter in pediatric dental patients sedated with 60mg/kg chloral hydrate and 25mg hydroxyzine. The following results were obtained : 1. The success rate of the sedation was 69.6% and there was no statistically significant difference among the groups based on the ages, weight and duration of the operative time. 2. Forty two percentage of the sedated patients showed the temporary hypoxia state and there was no statistically significant difference based on the ages and weights of the patients. But there was a statistically significant difference on the duration of the operative time.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.34 no.2
• /
• pp.234-246
• /
• 2007

The combination of chloral hydrate and hydroxyzine is one of the safest and most commonly used drug regimens for sedating young, uncooperative pediatric dental patients. Midazolam IM or IN and $N_2O/O_2$ inhalation is sometimes administered with chloral hydrate and hydroxyzinecombination when deeper and longer sedation is needed. The purpose of this study was to assess the outcome and safety of chloral hydrate, hydroxyzine and $N_2O/O_2$ in the sedation of a large number of uncooperative pediatric dental patients and to identify variables associated with their effectiveness. In a nine-month retrospective study, 171 records of sedation performed in 94 healthy children(male 46, female 48) with mean age of $30{\pm}8$ months were reviewed. The authors analyzed several variables such as age, sex, weight, methods of drug delivery, waiting time after drug delivery, treatment rendered, treatment time, adverse events, sedation outcome. Eighty five percent of sedation had success behavioral outcome. Sedation sessions rated success used more $N_2O/O_2$ administration and had longer treatment duration than sedation sessions rated failure. A children patient under 36 months of age had enough sleep by only oral administration and the mean waiting time of this case was significantly shorter than that of a children patient over 36 months of age. There was a clear correlation between age and $N_2O/O_2$ using tine, but no correlation between weight and $N_2O/O_2$ using time. There was no statistically significant difference among variables of treatment duration, $N_2O/O_2$ administration and adverse event.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.26 no.4
• /
• pp.589-594
• /
• 1999

There are some problems in inhalation sedation of non-cooperative pediatric patients. Usually the pediatric patients reject the nasal hood and there's no cooperation for administration of nitrous oxide gas. In mouth breathing patient, other technics of sedation such as intravenous or oral sedation or general anesthesia were recommended. Common causes of mouth breathing are common cold, allergic rhinitis, sinus problem, anatomical disorder, and habitual mouth-breathing. However in some patient not indicated the general anesthesia and high failure rate in oral and intravenous sedation. Administration of $N_2O-O_2$ with suction catheter was applied in full mouth breathing patient. Clinically effective sedation were occurred during procedure about 45 to 55 minutes. There's no any side effects by $N_2O-O_2$ inhalation sedation. The patients awoke at the end of the procedure and received 100% oxygen for 2-3 minutes. There's still some problems in use of the suction catheter such as air pollution of operation theater and elevate arterial carbon dioxide tension.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.39 no.1
• /
• pp.11-16
• /
• 2012

Effect of supplementary intranasal midazolam on oral sedation of children The purpose of this study was to compare the cardiopulmonary parameters of two sedation regimens during dental treatment: (1) Oral chloral hydrate(CH) and hydroxyzine(HZ) with nitrous oxide-oxygen($N_2O/O_2$) inhalation(CH-HZ group); (2) Oral chloral hydrate(CH) and hydroxyzine(HZ) with nitrous oxide-oxygen($N_2O/O_2$) inhalation and supplementary intranasal(IN) midazolam administration(MIDA group). Among the patients of OO hospital who received dental treatment under sedation over the past 5 years, 44 patients were selected for each group of CH-HZ and MIDA according to their age, gender and weight. Following parameters that were recorded every 5 minutes were compared: 1) Heart rate(HR) 2) $O_2$ saturation 3) End tidal carbon dioxide concentration($EtCO_2$) 4) Respiratory rate(RR) 33 patients of Group MIDA who have complete data of 15 minutes before and after supplementary IN midazolam administration were selected. And measurements 15 minutes before and after midazolam administration in same patient were evaluated. The results were as follows: 1. Heart rate was significantly higher in MIDA group than in CH-HZ group, but it was within normal range. 2. Comparing HR, $O_2$ saturation, EtCO2, RR between before and after of supplementary IN midazolam administration in the same patient, the differences were not statistically significant.