Inhalation Conscious Sedation with Nitrous Oxide and Oxygen as Alternative to General Anesthesia in Precooperative, Fearful, and Disabled Pediatric Dental Patients: A Large Survey on 688 Working Sessions

Abstract

Aim. To evaluate the effectiveness and the tolerability of the nitrous oxide sedation for dental treatment on a large pediatric sample constituting precooperative, fearful, and disabled patients. Methods. 472 noncooperating patients (aged 4 to 17) were treated under conscious sedation. The following data were calculated: average age; gender distribution; success/failure; adverse effects; number of treatments; kind of dental procedure undertaken; number of dental procedures for each working session; number of working sessions for each patient; differences between males and females and between healthy and disabled patients in relation to success; success in relation to age; and level of cooperation using Venham score. Results. 688 conscious sedations were carried out. The success was 86.3%. Adverse effects occurred in 2.5%. 1317 dental procedures were performed. In relation to the success, there was a statistically significant difference between healthy and disabled patients. Sex and age were not significant factors for the success. Venham score was higher at the first contact with the dentist than during the treatment. Conclusions. Inhalation conscious sedation represented an effective and safe method to obtain cooperation, even in very young patients, and it could reduce the number of pediatric patients referred to hospitals for general anesthesia.

Genel anestezi altında dental tedavi yapılan olguların değerlendirilmesi

“…Bu hastalarda kooperasyon kurulamadığı için diş tedavilerinde genel anestezi ve sedasyonsuz işlem yapmak nerdeyse imkansızdır. Literatürde bu hasta grubunda yapılmış bir çok yayın bulunmaktadır 7,9,11,13 . Bizim hastalarımızda da dental tedavinin süresini ve hastanın mevcut durumunu değerlendirerek işlemler sedasyon veya genel anestezi altında yapıldı.…”

Pain Experience and Behavior Management in Pediatric Dentistry: A Comparison between Traditional Local Anesthesia and the Wand Computerized Delivery System

“…Although the aim of local anesthesia is to eliminate pain during dental procedures, the fear connected to the needle puncture is frequently considered a reason for not visiting the dentist [ 4 – 6 ].…”

Moderate sedation with N2O in patients with special needs: Technical note

“…Patients observe a preoperative fasting period of 2 h for liquids and 8 h for solids, since N 2 O can stimulate nausea and/or vomiting. 3 Twenty minutes before entering the operating room (OR), patients receive oral (po) premedication with midazolam (pediatric patients 0.5 mg/kg up to 20 kg, then 10 mg up to 18 years; adults receive 5 mg, and senior patients (age > 65 years) 2-3 mg po). In the OR, patients are monitored with pulse oximetry (peripheral O 2 saturation and heart rate measurements) and, when clinically indicated, with noninvasive blood pressure monitoring.…”