Effect of afentanil combined with local nerve block in comfortable tooth extraction for children with dental phobia
Objective To investigate the effect of afentanil combined with local nerve block in comfortable tooth extraction for children with dental phobia.Methods A total of 116 children with dental phobia admitted to Xi'an Third Hospital from July 2021 to October 2023 were selected for the randomized controlled trial,and were divided into a study group and a control group by the random number table method,with 58 cases in each group.There were 21 males and 37 females in the control group;they were(7.26±0.83)years old.There were 24 males and 34 females in the study group;they were(7.42±0.78)years old.The control group took local nerve block,and the study group afentanil combined local nerve block.The general conditions of operation(operation time,discharge time,anesthesia time,time remove laryngeal mask,and sevoflurane dosage),postoperative pain[evaluated by Visual Analogue Scale(VAS)],hemodynamics[mean artery pressure(MAP)and heart rate(HR)],stress response[cortisol(COR)and adrenocor ticotropic hormore(ACTH)],operator satisfaction,the use rate of vasoactive drugs,and incidences of restlessness and adverse reactions during recovery were compared between the two groups by t and x2 tests.Results There were no differences in the operation time,discharge time,use rate of vasoactive drugs,and incidences of restlessness and adverse reactions between the two groups(all P＞0.05).The anesthesia time in the study group was longer than that in the control group[(49.89±8.20)min vs.(42.14±7.68)min](P＜0.05);the time to remove laryngeal mask in the study group was shorter than that in the control group[(5.41±1.76)min vs.(7.20±2.45)min];the sevoflurane dosage in the study group was lower than that in the control group[(36.11±4.63)ml vs.(42.27±5.81)ml];there were statistical differences(t=5.253,4.519,and 6.315;all P＜0.05).One,2,and 3 h after the surgery,the scores of VAS in the study group were lower than those in the control group[(2.72±0.49)vs.(3.45±0.56),(1.86±0.32)vs.(2.37±0.41),and(0.98±0.17)vs.(1.45±0.26)],with statistical differences(t=7.471,7.467,and 11.523;all P＜0.05).At T0,there were no statistical differences in the MAP and HR between the two groups.(both P＞0.05);at T1 and T2,the MAP and HR in the study group were lower than those in the control group,with statistical differences(t=3.260,3.658,2.511,and 3.581;all P＜0.05).Before the surgery,there were no statistical differences in the serum levels of ACTH and COR between the two groups(both P＞0.05);2 h after the surgery,the serum levels of ACTH and COR in the study group were lower than those in the control group[(44.05±6.19)ng/L vs.(54.18±7.26)ng/L and(182.45±22.04)ng/L vs.(216.06±25.73)ng/L],with statistical differences(t=8.086 and 7.555;both P＜0.05).The score of operator satisfaction in the study group was higher than that in the control group[(3.52±0.20)vs.(3.08±0.14)],with a statistical difference(t=13.726;P＜0.05).The incidence of restlessness in the study group was lower than that in the control group[32.76％(19/58)vs.51.72％(30/58)],with a statistical difference(x2=4.275;P＜0.05).Conclusion Afentanil combined with local nerve block has analgesic effect in comfortable tooth extraction for children with dental phobia,can reduce stress response,help maintain hemodynamic stability,improve the operator satisfaction,reduce sevoflurane dosage,and is safe and reliable.
万方数据
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