女性の抜歯時の交感神経活動と手術直後の歯科不安との関連について

Sympathetic Nerve Activity During Tooth Extraction in Women Is Related to Dental Anxiety Immediately After Surgery.

抄録

目的:

本研究では、歯科恐怖症や歯科不安を軽減するための介入策の開発に役立てることを目的として、下顎第三大臼歯抜歯時の自律神経系活動の変化と患者の術後の心理状態との関係を評価した。我々は，抜歯時の自律神経系活動の変化が術後の心理状態と関連するという仮説を立てた。

PURPOSE: This study assessed the relationship between changes in autonomic nervous system activity during impacted mandibular third molar extraction and a patient's postoperative psychological status, with the overarching aim of informing the development of interventions to reduce dental phobia and anxiety. We hypothesized that changes in autonomic nervous system activity during tooth extraction are related to postoperative psychology.

方法は以下の通りです。:

我々のプロスペクティブコホート研究では、下顎第三大臼歯抜歯時の心拍変動、心拍数（HR）、収縮期血圧（SBP）を記録した。心拍変動の値は，低周波（LF 0.04～0.15 Hz）と高周波（HF >0.15 Hz）の2つに分類した。LF/HF，HF，HR，SBPの相対比（術中対ベースライン）を中央値で高値群と低値群に分け，State Anxiety Inventory（STAI-S）の結果を相対比が高値群と低値群で比較した。

METHODS: In our prospective cohort study, heart rate variability, heart rate (HR), and systolic blood pressure (SBP) were recorded during impacted mandibular third molar extraction. Heart rate variability values were dichotomized as either low frequency (LF 0.04-0.15 Hz) or high frequency (HF >0.15 Hz). The relative ratios (intraoperative vs baseline) of LF/HF, HF, HR, and SBP were divided into high and low groups based on their median values; the State Anxiety Inventory (STAI-S) results were compared between the groups with high and low relative ratios.

結果:

34名の女性患者（年齢、28.23±1.05歳）のデータを解析した。術後のSTAI-Sの値は、術前の値よりも有意に低かった。LF/HF高値群の患者は、LF/HF低値群の患者に比べて、STAI-S値の変化が有意に低かった（P < .05）。HFが高い群と低い群、HR、SBPの間では、STAI-S値の変化に有意な差はなかった。

RESULTS: Data of 34 female patients (age, 28.23 ± 1.05 years) were analyzed. Postoperative STAI-S values were significantly lower than preoperative values. Patients in the high LF/HF group had a significantly lower change in STAI-S values than those in the low LF/HF group (P < .05). There were no significant differences in the change in STAI-S values between the groups with high and low HF, HR, or SBP.

結論:

交感神経系の活動が低い患者は、不安感が低かった。LF/HF指数は、ストレスの変化を示す最も感度の高い指標であった。歯科恐怖症の患者の交感神経活動を低下させるための最適な介入方法を開発するためには、さらなる研究が必要である。

CONCLUSIONS: Patients with low sympathetic nervous system activity had lower anxiety; the LF/HF index was the most sensitive indicator for changes in stress. Additional studies are required to develop optimal interventions for reducing sympathetic nerve activity in patients with dental phobia.