Effects of Oral Diazepam or Inhalatory Nitrous OxideOxygen for Conscious Sedation During Third Molar Surgery: A Randomized Controled Trial, Split Mouth Design

Abstract

Anxiety in dental surgery may lead to behavioral and physiological changes for the patient and constitute a frequent challenge for the oral surgeon. The objective of this study was to compare the effect of inhalatory nitrous oxide and oxygen (N 2 O/O 2) with oral diazepam conscious sedation in vital signs of patients undergone third molar extraction. Outpatients who needed removal of partially impacted, bilateral lower third molars, during the period of one year, were included. Each patient underwent conscious sedation with either oral diazepam or inhalatory N 2 O/O 2 on a randomized controlled trial, split-mouth design. Systolic and diastolic blood pressure, heart rate and oxygen blood saturation were the changes measured before, at the beginning and the end of the procedure. Also, surgical procedure duration was recorded. Data from vital signs were submitted to analysis of variance and the duration of the surgery to paired Student's t-test. Twenty-five healthy outpatients (13 women and 12 men) with a mean age of 21.6 years were studied. There was an increase in systolic and diastolic pressure and in heart rate in the beginning; these values decreased and stabilized at the end of the surgical procedure in both treatments (p < 0.001) being lower in N 2 O/O 2 but without difference between treatments. The surgical procedure duration was lower and occurred an expected increase of oximetry under N 2 O/O 2 sedation (p < 0.001). Both treatments were effective for the conscious sedation but N 2 O/O 2 showed better outcomes, mainly in duration of the surgery.

Controle da ansiedade com benzodiazepínicos em cirurgias de terceiros molares inferior: revisão sistemática

“…Hemodynamic parameters are frequently used in clinical studies of third molar extraction to observe cardiac and respiratory changes at different surgical times , GANZBERG et al, 2005, USTUN et al, 2006, CHEUNG et al, 2007, STUDER et al, 2012, DANTAS et al, 2017, FARAH et al, 2019, CAVALCANTI et al, 2020.…”