Alternative TitleEffect of intravenous sedation on autonomic nerve activity and the psychological state during tooth extraction : A prospective non-randomized controlled trial
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博士論文全文, 博士論文要旨, 最終試験結果の要旨, 論文審査の要旨
Purpose: Intravenous sedation is considered to decrease patient anxiety and tension during dental treatment, thereby reducing fluctuations in autonomic nerve activity and the risk of medical emergencies. We hypothesized that intravenous sedation would suppress the sympathetic nervous system during tooth extraction and relieve patient anxiety. Accordingly, the purpose of this study was to investigate the effects of intravenous sedation on autonomic nerve activity and psychological state during impacted mandibular third molar (IMTM) extraction.Methods: This prospective study included 40 healthy women scheduled for IMTM extraction under local anesthesia alone (control group; n = 20) or local anesthesia and intravenous sedation (sedation group; n = 20); of these, 34 women were evalu-ated. Heart rate variability (HRV) was analyzed to evaluate autonomic nerve activity. HRV and circulatory dynamics were measured during the treatment. The Modified Dental Anxiety scale and State-Trait Anxiety Inventory (STAI-S and STAI-T) scores were obtained before treatment. STAI-S scores were also obtained after treatment. Descriptive and bivariate statistical analyses were conducted, and a P-value <.05 was considered statistically significant.Results: The low-frequency/high-frequency ratio was lower in the sedation group than in the control group (P< .01). Compared with the control group, the sedation group showed a significantly greater decrease in post-treatment STAI-S scores rela-tive to pre-treatment scores (P< .01).Conclusions: The findings suggest that sedation suppresses the sympathetic nervous system during IMTM extraction and decreases anxiety after the extraction. Further research should elucidate the mechanisms by which sedation suppresses the sympa-thetic nervous system.This is the peer reviewed version of the following article:Minako Uchino, Kaoru Yamashita, Toshiro Kibe, Rumi Shidou, Atsushi Kohjitani, Mitsutaka SugimuraEffects of intravenous sedation on autonomic nerve activity and the psychological state during tooth extraction: A prospective non-randomized controlled trialOral Science International (2021), 18(2), 135–140© 2020 Japanese Stomatological Societywhich has been published in final form at https://doi.org/10.1002/osi2.1094This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.
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