scholarly journals A Bibliometric Analysis of the 100 Most Cited Articles on Nitrous Oxide Conscious Sedation

1979 ◽  
Vol 99 (4) ◽  
pp. 624-626 ◽  
Author(s):  
Joseph Barber ◽  
David Donaldson ◽  
Susan Ramras ◽  
Gerald D. Allen

Author(s):  
Nicholas Longridge ◽  
Pete Clarke ◽  
Raheel Aftab ◽  
Tariq Ali

The ability to practise dentistry and provide invasive treatments to pa­tients is based on the ability to make such procedures comfortable and acceptable for patients to tolerate, as well as manage post- operative pain. A good working knowledge of the different treatment modalities available, and analgesic agents that can be prescribed, is key to effective management of patients. This must include the indications and limita­tions of each modality. The pharmacology of most drugs used in modern- day dentistry has changed very little since their introduction, some as far back as 100 years ago. However, it is important to understand the processes regarding their method of action, their effect on the human body, and their indica­tions and contraindications. All of these factors must be considered to maximize the clinical benefit to the patient. Several guidelines regarding the use of conscious sedation in dentistry have recently been introduced, and it is important that those wishing to provide conscious sedation and refer patients appropriately familiarize themselves with these guidelines. Key topics include: ● Principles of analgesia, anaesthesia, and conscious sedation ● Pharmacology and pharmacodynamics of commonly used pharmaco­logical agents ● Indications and contraindications of commonly used pharmacological agents ● Conscious sedation with nitrous oxide ● Conscious sedation with midazolam ● General anaesthesia ● Treatment planning for conscious sedation and general anaesthesia ● Managing complications and adverse reactions


2003 ◽  
Vol 26 (2) ◽  
pp. 179-180 ◽  
Author(s):  
Hani Eid

Most (99%) patients treated at this university clinic do not need any form of sedation as rapport and behavioral management skills are more than sufficient and are safe. Those aged 1 to 5 years, who needed the use of oral sedation (Midazolam), showed 70% success. Those who needed nitrous oxide / oxygen ranged in age from 8 to 18 years and were later treated without any sort of conscious sedation after one or two sessions of nitrous oxide / oxygen sedation.


2001 ◽  
Vol 94 (4) ◽  
pp. 585-592 ◽  
Author(s):  
Anthony G. Doufas ◽  
Maryam Bakhshandeh ◽  
Andrew R. Bjorksten ◽  
Robert Greif ◽  
Daniel I. Sessler

Background The authors evaluated a device designed to provide conscious sedation with propofol (propofol-air), or propofol combined with 50% nitrous oxide (N2O; propofol-N2O). An element of this device is the automated responsiveness test (ART), a method for confirming that patients remain conscious. The authors tested the hypotheses that the ART predicts loss of consciousness and that failure to respond to the ART precedes sedation-induced respiratory or hemodynamic toxicity. Methods The protocol consisted of sequential 15-min cycles in 20 volunteers. After a 15-min control period, propofol was infused to an initial target effect-site concentration of 0.0 microg/ml with N2O or 1.5 microg/ml with air. Subsequently, the propofol target effect-site concentration was increased by a designated increment (0.25 and 0.5 microg/ml) and the process repeated. This sequence was continued until loss of consciousness, as defined by an Observer's Assessment of Alertness/Sedation (OAA/S) score of 10/20 or less, or until an adverse physiologic event was detected. Results The OAA/S score at which only 50% of the volunteers were able to respond to the ART (P50) during propofol-N2O was 11.1 of 20 (95% confidence interval [CI]: 10.6-11.8); the analogous P50 was 11.8 of 20 (95% CI: 11.4-12.3) with propofol-air. Failure to respond to the ART occurred at a plasma propofol concentration of 0.7 +/- 0.6 microg/ml with propofol-N2O and 1.6 +/- 0.6 microg/ml with propofol-air, whereas loss of consciousness occurred at 1.2 +/- 0.8 microg/ml and 1.9 +/- 0.7 microg/ml, respectively. There were no false-normal ART responses. Conclusion The ART can guide individual titration of propofol because failure to respond to responsiveness testing precedes loss of consciousness and is not susceptible to false-normal responses. The use of N2O with propofol for conscious sedation decreases the predictive accuracy of the ART.


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