PDF(Pubmed)
Abstract：
This study compared the safety of general anesthesia (GA) and intravenous sedation (IVS) in patients who underwent extraction of one or more third molars. Data from 1260 patients (GA group, n = 1043; IVS group, n = 217) were retrospectively analyzed, including demographics, preoperative data, intraoperative hemodynamic parameters (blood pressure, heart rate, and oxygen saturation level), and medications administered intraoperatively and postoperatively. The incidence of intraoperative circulatory variations, surgery and anesthesia durations, postoperative complications, and medication use were assessed and compared. The GA group had longer anesthesia and surgery durations, a higher incidence of hypotension, and a higher frequency of postoperative analgesic use than the IVS group. Dexmedetomidine was the most frequently used sedative agent. The IVS group had a lower incidence of intraoperative hypotension but they had a higher need for vasopressors in the recovery room. Both anesthesia methods maintained satisfactory oxygen saturation levels and sufficient anesthesia throughout the procedure, but they showed different characteristics regarding the duration of surgery and anesthesia duration, hemodynamic stability, and postoperative analgesic needs. IVS may be preferable for patients at risk of cardiovascular complications such as hypotension or tachycardia during surgery.
摘要：
这项研究比较了接受一个或多个第三磨牙拔除的患者的全身麻醉（GA）和静脉镇静（IVS）的安全性。数据来自1260名患者(GA组，n=1043；IVS组，n=217)进行回顾性分析，包括人口统计，术前数据,术中血流动力学参数（血压，心率,和氧饱和度)，以及术中和术后给予的药物。术中循环变异的发生率，手术和麻醉持续时间，术后并发症,和药物使用情况进行评估和比较。GA组麻醉和手术持续时间较长，低血压的发生率较高,术后使用镇痛药的频率高于IVS组。右美托咪定是最常用的镇静剂。IVS组术中低血压的发生率较低，但他们在恢复室对血管加压药的需求较高。两种麻醉方法在整个过程中都保持了令人满意的氧饱和度水平和足够的麻醉。但是它们在手术持续时间和麻醉持续时间方面表现出不同的特征，血液动力学稳定性，和术后镇痛的需要。对于在手术期间有心血管并发症如低血压或心动过速风险的患者，IVS可能是优选的。
