Assessment of hypoxia, sedation level, and adverse events occurring during inhalation sedation using preadjusted mix of 30% nitrous oxide + 70%oxygen

Samir, P V; Namineni, Srinivas; Sarada, P

doi:10.4103/jisppd.jisppd_15_17

Cited by 11 publications

(7 citation statements)

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“…The American Academy of Pediatric Dentistry (AAPD) guideline 22 recommends only light meal or clear liquids 2 hours prior to the appointment. 23 , 24 The same was observed in the present study.…”

Section: Discussionsupporting

confidence: 92%

“…Slow induction or titration is a method of administering a drug in incremental amounts until a desired end point is reached, and this method was used to deliver N 2 O to the participants in this study. Samir et al 23 reported that rapid induction of a preadjusted mix of 30% N 2 O and 70% O 2 has the same efficacy as slow induction in achieving optimal sedation in lesser time. However, the titration technique is regarded as the current standard of care when administering N 2 O–O 2 for sedation.…”

Section: Discussionmentioning

confidence: 99%

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Comparative Assessment of Anxiety during Inferior Alveolar Nerve Block under Nitrous Oxide + Oxygen and Oxygen Inhalation Sedation in Children Aged 3–12 Years: A Randomized Clinical Trial

Dave¹,

Thomas²,

Shah³

et al. 2023

International Journal of Clinical Pediatric Dentistry

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A bstract Aim A comparative evaluation of children's anxiety with the use of nitrous oxide–oxygen (N 2 O–O 2 ) inhalation sedation during the administration of inferior alveolar nerve block (IANB). Materials and methodology A total of 60 children between 3 and 12 years of age, with Frankl's behavior rating of 2–3 requiring IANB for any dental procedure were enrolled in this randomized clinical study. Group I ( n = 30) received N 2 O and oxygen inhalation sedation at a concentration in the range of 25–50%, whereas group II ( n = 30) received 100% O 2 as a placebo. The physiological parameters like pulse rate, respiration, blood pressure, and O 2 saturation were measured at the baseline, intraoperatively [during and after administration of local anesthesia (LA)] and postoperatively after the termination of the gases in both groups. The sedation level was measured intraoperatively (before administration of LA) using the Ramsay Sedation Score (RSS). The discomfort and anxiety were measured at the baseline, intraoperatively, and postoperatively using the Face, Legs, Activity, Cry, Consolability (FLACC) behavior scale. The data were evaluated using the statistical software International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) statistics 20.0. Results There was a significant difference in the FLACC scores between the two groups, intraoperatively ( p -value—0.002), and postoperatively ( p -value—0.049). The mean of the RSS for group I was 2.80 + 1.03, and for group II was 1.80 + 0.81. All the physiological parameters recorded were within the normal range. Conclusion The use of N 2 O–O 2 inhalation improved the anxiety levels in children while receiving the IANB and showed significant anxiolytic and sedative effects as compared to O 2 inhalation. Clinical significance Nitrous oxide–oxygen (N 2 O–O 2 ) inhalation can be used as a nonpharmacological behavior management adjunct for invasive treatments for children with utmost comfort for the child. How to cite this article Thomas PS, Dave BH, Shah DJ, et al. Comparative Assessment of Anxiety during Inferior Alveolar Nerve Block under Nitrous Oxide + Oxygen and Oxygen Inhalation Sedation in Children Aged 3–12 Years: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2023;16(1):30-36.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Comparative Assessment of Anxiety during Inferior Alveolar Nerve Block under Nitrous Oxide + Oxygen and Oxygen Inhalation Sedation in Children Aged 3–12 Years: A Randomized Clinical Trial

Dave¹,

Thomas²,

Shah³

et al. 2023

International Journal of Clinical Pediatric Dentistry

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“…Hand searches of the bibliographies of full-text articles identified 28 additional articles. After full-text evaluation, 19 RCTs [ 13 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 ] published between May 1988 and August 2019 were finally selected for the review. The study screening, selection process, and reasons for exclusion are depicted in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…In one study [ 40 ], both the intervention and control groups received NOIS but they were administered the mixture using two different techniques. The two groups had a success rate of 100%.…”

Section: Resultsmentioning

confidence: 99%

Success rate of nitrous oxide-oxygen procedural sedation in dental patients: systematic review and meta-analysis

Rossit

Gil-Manich

Ribera-Uribe

2021

J Dent Anesth Pain Med

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The aim of this systematic review was to determine the success rate of nitrous oxide-oxygen procedural sedation (NOIS) in dentistry. A systematic digital search was conducted for publications or reports of randomized controlled trials evaluating the clinical performance of NOIS. Abstracts of research papers were screened for suitability, and full-text articles were obtained for those who met the inclusion and exclusion criteria accordingly. The quality of the studies was assessed using the revised Cochrane risk-of-bias tool (RoB 2). A total of 19 articles (eight randomized clinical trials with parallel intervention groups and 11 crossover trials), published between May 1988 and August 2019, were finally selected for this review. The studies followed 1293 patients reporting NOIS success rates, with a cumulative mean value of 94.9% (95% CI: 88.8–98.9%). Thirteen trials were conducted on pediatric populations (1098 patients), and the remaining six were conducted on adults (195 patients), with cumulative efficacy rates of 91.9% (95% CI: 82.5–98.1%) and 99.9% (95% CI: 97.7–100.0%), respectively. The difference was statistically significant (P = 0.002). Completion of treatment and Section IV of the Houpt scale were the most used efficacy criteria. Within the limitations of this systematic review, the present study provides important information on the efficacy rate of NOIS. However, further well-designed and well-documented clinical trials are required and there is a need to develop guidelines for standardization of criteria and definition of success in procedural sedation. Currently, completion of treatment is the most used parameter in clinical practice, though many others also do exist at the same time. To maximize NOIS efficacy, clinicians should strictly consider appropriate indications for the procedure.

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“…N 2 O is a nonirritating, colorless, inert gas with a faint sweet smell and odor. It is an effective analgesic/anxiolytic agent which causes central nervous system depression and euphoria with little effect on the respiratory system [10,11] . N 2 O-O 2 inhalation sedation is one of the most common pharmacological means of behavioral modification advocated in children and anxious adults owing to its unique properties such as high efficiency, potency, fast onset, rapid recovery, and least adverse effects [8] .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of nitrous oxide inhalation sedation during inferior alveolar block administration in children aged 7-10 years

Basheer¹,

Maroofa²,

Mansha³

2022

Int. J. Appl. Dent. Sci.

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Background: To evaluate the nitrous oxide-oxygen inhalation sedation during inferior alveolar block administration in children. Materials & Methods:A total of 50 children of age 7-10 years, with a treatment plan of extraction of primary teeth were enrolled in the study. They were divided into 2 groups as N2O-O2 and oxygen. Those who presented with clinical conditions contraindicating the use of N2O-O2 or having known allergy to lignocaine were excluded from the study. Data was collected and result was analysed using SPSS software. The level of significance was at p≤0.05. Results: A total of 50 children were enrolled, 25 in each group. There was a significantly lower pain reaction to local anesthetic administration in the N2O-O 2 group (p<0.01). Scoring was done. In O2 administrated patients, 84% were in deep sedation during and even after the procedure. In N2O-O2, 32% patients were in light sedation after the procedure whereas 20% were in light sedation during the procedure. Conclusion: N2O-O2 inhalation showed better results as vital signs were normal and treatment completed successfully.

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Assessment of hypoxia, sedation level, and adverse events occurring during inhalation sedation using preadjusted mix of 30% nitrous oxide + 70%oxygen

Cited by 11 publications

References 0 publications

Comparative Assessment of Anxiety during Inferior Alveolar Nerve Block under Nitrous Oxide + Oxygen and Oxygen Inhalation Sedation in Children Aged 3–12 Years: A Randomized Clinical Trial

Comparative Assessment of Anxiety during Inferior Alveolar Nerve Block under Nitrous Oxide + Oxygen and Oxygen Inhalation Sedation in Children Aged 3–12 Years: A Randomized Clinical Trial

Success rate of nitrous oxide-oxygen procedural sedation in dental patients: systematic review and meta-analysis

Evaluation of nitrous oxide inhalation sedation during inferior alveolar block administration in children aged 7-10 years

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