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<p>Extraction surgery often induces anxiety and fear in patients with dental phobia. Traditional sedation protocols have limitations such as insufficient depth of sedation and incomplete analgesia. Remimazolam tosilate (RT) and remifentanil hydrochloride (RH), as novel sedative-analgesic agents, have pharmacokinetic advantages of rapid onset, short duration of action, and no accumulation, and may be more suitable for the management of phobia during extraction surgery. This study aims to investigate the efficacy of RT combined with RH in alleviating phobia in patients undergoing extraction and its clinical safety. A total of 262 patients undergoing complex extraction surgery were assigned to the experimental group (EG, <i>n</i> = 131) and the control group (CG, <i>n</i> = 131). The EG was administered an individualized regimen of RT + RH, while the CG received propofol intravenous sedation. The level of fear was assessed using the dental anxiety scale (DAS, with a score range of 11–55, ≥31 indicates severe anxiety). Sedation depth (Ramsay score), visual analogue scale (VAS), vital signs, and adverse events were monitored concurrently. Patient satisfaction was also recorded (on a scale of 0–10, with ≥7 indicating satisfaction). The DAS score of the EG was significantly lower than that of the CG after surgery (12.3 ± 3.2 vs 22.5 ± 4.7, <i>P</i> &lt; 0.05). The VAS pain score (1.23 ± 0.45 vs 3.48 ± 1.21, <i>P</i> &lt; 0.05) and pharyngeal reflex score (1.8 ± 0.6 vs 3.5 ± 0.9, <i>P</i> &lt; 0.05) of the EG were also significantly better than those of the CG. The patient satisfaction score of the EG (9.12 ± 0.89) was significantly higher than that of the CG (7.23 ± 1.45) (<i>P</i> &lt; 0.05). Moreover, the postoperative systolic blood pressure (122.3 ± 10.5 vs 135.6 ± 12.3&#xa0;mmHg), heart rate (72.5 ± 8.3 vs 85.6 ± 9.7 beats/min), and other vital signs of the EG were more stable, and the incidence of angina (0.76% vs 2.29%) and hypertension (1.53% vs 3.82%) were significantly reduced (<i>P</i> &lt; 0.05). The combination of RT and RH can effectively alleviate dental phobia in patients undergoing extraction, enhance the effects of sedation and analgesia as well as patient comfort, and has good safety, which is worthy of clinical application and promotion.</p>

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Remimazolam tosilate combined with remifentanil hydrochloride alleviates dental phobia in patients undergoing tooth extraction surgeries

  • 期刊论文

  • 发表日期：

    2025年11月1日

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  • Chen Cao,
  • Huiyu Yan,
  • Chan Cheng,
  • Lu Li,
  • Kaixuan Wang,
  • Chen Wang,
  • Chuxiong Pan

摘要

Extraction surgery often induces anxiety and fear in patients with dental phobia. Traditional sedation protocols have limitations such as insufficient depth of sedation and incomplete analgesia. Remimazolam tosilate (RT) and remifentanil hydrochloride (RH), as novel sedative-analgesic agents, have pharmacokinetic advantages of rapid onset, short duration of action, and no accumulation, and may be more suitable for the management of phobia during extraction surgery. This study aims to investigate the efficacy of RT combined with RH in alleviating phobia in patients undergoing extraction and its clinical safety. A total of 262 patients undergoing complex extraction surgery were assigned to the experimental group (EG, n = 131) and the control group (CG, n = 131). The EG was administered an individualized regimen of RT + RH, while the CG received propofol intravenous sedation. The level of fear was assessed using the dental anxiety scale (DAS, with a score range of 11–55, ≥31 indicates severe anxiety). Sedation depth (Ramsay score), visual analogue scale (VAS), vital signs, and adverse events were monitored concurrently. Patient satisfaction was also recorded (on a scale of 0–10, with ≥7 indicating satisfaction). The DAS score of the EG was significantly lower than that of the CG after surgery (12.3 ± 3.2 vs 22.5 ± 4.7, P < 0.05). The VAS pain score (1.23 ± 0.45 vs 3.48 ± 1.21, P < 0.05) and pharyngeal reflex score (1.8 ± 0.6 vs 3.5 ± 0.9, P < 0.05) of the EG were also significantly better than those of the CG. The patient satisfaction score of the EG (9.12 ± 0.89) was significantly higher than that of the CG (7.23 ± 1.45) (P < 0.05). Moreover, the postoperative systolic blood pressure (122.3 ± 10.5 vs 135.6 ± 12.3 mmHg), heart rate (72.5 ± 8.3 vs 85.6 ± 9.7 beats/min), and other vital signs of the EG were more stable, and the incidence of angina (0.76% vs 2.29%) and hypertension (1.53% vs 3.82%) were significantly reduced (P < 0.05). The combination of RT and RH can effectively alleviate dental phobia in patients undergoing extraction, enhance the effects of sedation and analgesia as well as patient comfort, and has good safety, which is worthy of clinical application and promotion.