scholarly journals Risk of respiratory depression at use of nitrous oxide on individuals with cerebral palsy: a clinical trial

2021 ◽  
Vol 10 (13) ◽  
pp. e198101320774
Author(s):  
Fernando Martins Baeder ◽  
Daniel Furtado Silva ◽  
Ana Carolina Lyra de Albuquerque ◽  
Dênis Clay Lopes dos Santos ◽  
Andrea Pavanello ◽  
...  
Keyword(s):  
Nitrous Oxide ◽  
Cerebral Palsy ◽  
Respiratory Depression ◽  
Dental Care ◽  
Conscious Sedation ◽  
Dental Treatment ◽  
Outpatient Setting ◽  
Significance Level ◽  
Significant Difference ◽  
N2o Titration

The dental care for individuals with cerebral palsy (CP) often result in the referral of patients for general anesthesia. Conscious sedation with nitrous oxide (N2O) could be an alternative resource, from a behavioral and physiological point of view, and could favor dental care in an outpatient setting. This study aimed to evaluate the influence of conscious sedation with N2O on respiratory rate (RR) and oxygen saturation (SpO2) in the dental treatment of individuals with CP. Seventy-seven patients with CP, over 3 years old, regardless of gender and ethnicity, were evaluated with the measurement of N2O titration, RR and SpO2 in four moments: initial, 5 minutes after sedation, 10 minutes after anesthesia and 5 minutes after removal of the N2O. Student's t test and ANOVA F were used, with a significance level of 5%. The variation in N2O titration did not generate significant variation in RR (p = 0.122). There was a significant difference in SpO2 between T1 and other times. It can be said that conscious sedation is not influenced by N2O titration, does not cause respiratory depression or any clinically significant change in SpO2, confirming the safety of use in an outpatient setting.

scholarly journals Conscious Sedation with Nitrous Oxide to control Stress during Dental Treatment in Patients with Cerebral Palsy: An Experimental Clinical Trial

2017 ◽  
Vol 10 (4) ◽  
pp. 384-390 ◽  
Author(s):  
Fernando M Baeder ◽  
Daniel F Silva ◽  
Ana CL de Albuquerque ◽  
Maria TBR Santos
Keyword(s):  
Clinical Trial ◽  
Nitrous Oxide ◽  
Cerebral Palsy ◽  
Conscious Sedation ◽  
Dental Treatment ◽  
Test Analysis ◽  
Significance Level ◽  
Dental Procedures ◽  
Chi Squared ◽  
Student’S T

ABSTRACT Introduction Individuals with cerebral palsy (CP) often present with oral alterations that impact oral health and require dental treatment. Aim This study aimed to evaluate the use of conscious sedation with nitrous oxide (N2O) to control stress during dental treatment in individuals with CP using as parameters: Venham score (VS), heart rate (HR), and respiratory rate (RR). Materials and methods A total of 77 CP patients >3 years of age with a mean age of 11.8 (± 6.4) years were evaluated in a rehabilitation center. Stress control was measured at the following time points: T1 (presedation), T2 (induction), T3 (sedated patient), and T4 (end). Student's t-test, the Chi-squared test, analysis of variance (ANOVA), and the McNemar test were used. The significance level was 5%. Results Sedation ranged between 10 and 60% N2O, with an average of 35.6% (± 10.4). The RR did not vary among the times (p = 0.12). The HR and VS varied significantly between times (p < 0.001), as significantly higher values of HR were observed at T1. Conclusion Conscious sedation with N2O during dental care controls stress in CP patients, as verified by a decrease in HR, and does not promote respiratory depression. Higher concentrations of N2O are recommended for CP patients with tachycardia. Clinical significance Sedation modifies behavior during dental procedures, facilitating patient collaboration. How to cite this article Baeder FM, Silva DF, de Albuquerque ACL, Santos MTBR. Conscious Sedation with Nitrous Oxide to control Stress during Dental Treatment in Patients with Cerebral Palsy: An Experimental Clinical Trial. Int J Clin Pediatr Dent 2017;10(4):384-390.

scholarly journals Temperament as a Predictor of Nitrous Oxide Inhalation Sedation Success

2017 ◽  
Vol 64 (1) ◽  
pp. 17-21 ◽  
Author(s):  
Travis M. Nelson ◽  
Thomas M. Griffith ◽  
Katherine J. Lane ◽  
Sarat Thikkurissy ◽  
JoAnna M. Scott
Keyword(s):  
Nitrous Oxide ◽  
Inhibitory Control ◽  
Dental Care ◽  
Effortful Control ◽  
Dental Treatment ◽  
Short Form ◽  
Child Temperament ◽  
Health Insurance Status ◽  
Inhalation Sedation ◽  
Significant Difference

Little is known about implications of temperament for children who receive nitrous oxide inhalation sedation (N2O/O2) for dental care. The aim of this study was to investigate whether child temperament is associated with success in N2O/O2. Child-caregiver dyads were enrolled from patients aged 36–95 months receiving dental care with N2O/O2 at a university-based pediatric dental clinic. To assess child temperament, 48 caregivers completed the Children's Behavior Questionnaire Short Form. Patient behavior was abstracted from Frankl scores recorded in the patient's chart. The overall behavioral failure rate was 15% (n = 7/48). There was no significant difference in sedation outcome associated with sex, health, insurance status, or complexity of treatment provided. Sedation outcome was significantly associated with the broad temperament domain of Effortful Control and its subscales Attentional Focusing and Inhibitory Control. The Negative Affectivity subscales of Frustration, Sadness, and Soothability and the Extraversion/Surgency subscales Activity and Impulsivity were also significantly associated with sedation outcome. The results of this study suggest that Effortful Control is associated with behavior during dental treatment with N2O/O2. The subscales of Attention Focusing, Inhibitory Control, Frustration, Fear, Sadness, Soothability, Activity, and Impulsivity may also be important determinants of child behavior during dental treatment.

scholarly journals 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

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Angela Galeotti ◽  
Annelyse Garret Bernardin ◽  
Vincenzo D’Antò ◽  
Gianmaria Fabrizio Ferrazzano ◽  
Tina Gentile ◽  
...  
Keyword(s):  
Nitrous Oxide ◽  
Adverse Effects ◽  
General Anesthesia ◽  
Conscious Sedation ◽  
Dental Treatment ◽  
Young Patients ◽  
Dental Patients ◽  
Dental Procedures ◽  
Significant Difference ◽  
Disabled Patients

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.

Dental care for the bariatric patient

Dental Update ◽  
2021 ◽  
Vol 48 (4) ◽  
pp. 302-306
Author(s):  
Jessica Hamilton ◽  
Mary Gittins ◽  
Andrew Geddis-Regan ◽  
Graham Walton
Keyword(s):  
General Anaesthesia ◽  
Dental Care ◽  
Clinical Relevance ◽  
Conscious Sedation ◽  
Dental Treatment ◽  
Careful Consideration ◽  
Equitable Access ◽  
Bariatric Patient ◽  
Access To Dental Care ◽  
Obese Population

As the overweight and obese population increases, one must be mindful of the implications on the delivery of dental care to this group. Appropriate facilities must be available, which may warrant structural and equipment adaptations to clinical and non-clinical areas. The complexity of dental treatment planning and delivery may be compounded by medical comorbidities, and careful consideration must be given to the suitability and safety of conscious sedation and general anaesthesia in order to facilitate treatment. This article aims to discuss how safe provision and equitable access to dental care can be achieved for the bariatric population. CPD/Clinical Relevance: This article aims to discuss the challenges posed by the increase in the overweight and obese population and considerations to be taken for provision of safe and equitable bariatric dental care.

A patient information video for treatment under intravenous conscious sedation: considerations, challenges and prospects

Dental Update ◽  
2021 ◽  
Vol 48 (9) ◽  
pp. 752-758
Author(s):  
Harjit Tagar ◽  
Omesh Modgill ◽  
Jashme Patel ◽  
Julie Edwards ◽  
Olamide Obisesan
Keyword(s):  
Patient Experience ◽  
Patient Information ◽  
Dental Care ◽  
Conscious Sedation ◽  
Dental Treatment ◽  
Digital Health ◽  
Related Information ◽  
Health Related ◽  
The Impact ◽  
Insight Into

This article describes the use of a newly developed animation for the delivery of patient information pertinent to dental treatment performed under intravenous conscious sedation, and provides an understanding of how digital health-related information impacts upon the patient experience. This article provides insight into the rationale for using animation as a means to deliver healthcare-related information, the process undertaken to develop this animation and how the themes and imagery in the animation can be used more broadly to further enhance the patient experience in primary and secondary dental care settings. CPD/Clinical Relevance: This article outlines the process of developing an animation for patient information and the impact animation can have upon patient experience locally as an aid to delivering instructions.

Oral rehabilitation under dental general anesthesia, conscious sedation, and conventional techniques in patients affected by cerebral palsy

2004 ◽  
Vol 28 (4) ◽  
pp. 279-284 ◽  
Author(s):  
Juan Pablo Loyola-Rodriguez ◽  
Ana Alicia Aguilera-Morelos ◽  
Miguel Angel Santos-Diaz ◽  
Veronica Zavala-Alonso ◽  
Claudia Davila-Perez ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
General Anesthesia ◽  
Conscious Sedation ◽  
Dental Treatment ◽  
School Setting ◽  
Adolescent And Young Adult ◽  
Dental School ◽  
Discharge Process ◽  
Oral Rehabilitation ◽  
Anterior Teeth

The purpose of this report is to find the use of different alternatives for dental treatment, from general anesthesia to conventional techniques, in patients affected by cerebral palsy (CP) in a dental school setting.The sample was divided into two groups: (1) children, and (2) adolescents and young adults; 38 patients (20 female and 18 male) with diagnostic of CP were included. Risks and benefits of conscious sedation and general anesthesia were written into a consent form and these were discussed with parents or guardians of each affected patient.The mean age was 7.14 ± 2.2 years for children's group and 18.5 ± 3.06 years for adolescent and young adult group.Most children (77.3%) were classified as ASA II with a level of behavior I-II according to Frankl's scale and these patients were treated under general anesthesia (GA). For patients that were classified as of positive behavior with little necessity of dental procedures, independent of the medically compromised level, dental treatment was done with conventional techniques or with conscious sedation. Dental frequency procedures were as follows: composites, dental prophylaxis, and dental extractions in children; in adolescents and adults, important to point out is that in anterior teeth and molars endodontic treatment, and surgical procedures increased in frequency. The mixture sevoflurane-propofol worked well during pre-, peri-, and post-operative procedures. During the discharge process, most patients needed a recovery of 20-40 minutes, after which they were awake and oriented, breathing comfortably with stable vital signs. It was concluded that GA with sevoflurane-propofol and conscious sedation are an excellent tool to provide dental treatment in CP patients in a dental school setting without most of the major postoperative complications, such as nausea and vomiting.

scholarly journals The impact of Covid-19 pandemic over the dental patients

2021 ◽  
Vol 10 (11) ◽  
pp. e252101119502
Author(s):  
Lara Steffany de Carvalho ◽  
Caroline Trefiglio Rocha ◽  
Rafael de Aguiar Vilela Júnior ◽  
Ivan Balducci ◽  
Amjad Abu Hasna
Keyword(s):  
Dental Care ◽  
Dental Treatment ◽  
Cross Contamination ◽  
Dental Patients ◽  
Significant Difference ◽  
Dental Offices ◽  
Group 2 ◽  
Respiratory Droplets ◽  
The Impact ◽  
Group 1

Objective: Covid-19 is a highly infectious disease; it is transmitted by patients’ secretions and respiratory droplets SARS-CoV-2 was detected in patients saliva making dental care professionals more susceptible for contamination and the patient less safe while seeking the dental treatment. Methodology: This quantitative study was elaborated through a questionnaire for patients who frequently seek dental care in private and publica dental care units. A total of 205 over-18 patients were included, those who left one or more questions without answer were excluded. Participants were able to refuse to answer any question or to participate in the questionnaire at all. The questionnaire was composed of five questions. Participants were divided into two groups: Group 1: private dental offices patients (n=98); Group 2: public dental clinic patients (n=107). Results: there was a significant difference between groups 1 and 2, in which 50% of group 1 feel safe while seeking dental care during the Covid-19 pandemic in comparison with 72.89% of group 2. There was no significant difference between groups 1 and 2, in which 93.87 and 94.39% of groups 1 and 2 respectively feel safe with the professionals' PPE and consider it sufficient. About 59.81% of the participants of group 2 do not feel insecure with the cross contamination caused by SARS-CoV-2 in collective health care units. Finally, there was a significant difference between groups 1 and 2, in which 74.48% of group 1 prefer to be attended by vaccinated professionals, instead of only 56.07% of group 2. Conclusion: it was concluded that not all dental patients feel safe while seeking dental treatment during the Covid-19 pandemic, however, they consider the professional PPE sufficient. Patients feel safe to be attended by vaccinated professionals.

scholarly journals Exploring the Effect on 5 Senses in Children under Nitrous Oxide Sedation

2021 ◽  
Vol 10 (38) ◽  
pp. 3365-3369
Author(s):  
Vinita Goyel ◽  
Aman Jain ◽  
Shivani Mathur ◽  
Vinod Sachdev ◽  
Shambhavi Singh
Keyword(s):  
Nitrous Oxide ◽  
Dental Treatment ◽  
Rating Score ◽  
Sound Perception ◽  
Key Words Vision ◽  
Significant Difference ◽  
Behaviour Rating ◽  
Baseline Values ◽  
The Brain ◽  
Normal Perception

BACKGROUND Sensation and perception are two separate processes that are very closely related. Sensation is the input about the outside world obtained by our sensory receptors while perception is the difficult system by which the brain selects, organizes and interprets these sensations. Effects of nitrous oxide on the sensation and perception has not been unturned although role in physiological, anxiolytic, behavioural, psychomotor and analgesic parameters have been examined in both children and adults. The human senses have long been unnoticed, despite their responsiveness being of great importance. The purpose of this study was to evaluate the effectiveness of nitrous oxide inhalation sedation on 5 senses i.e. sight, hearing, touch, smell and taste at different titrations of nitrous oxide and oxygen. METHODS 7 to 12 years old children with Frankl’s behaviour rating score of 2, 3 and 4 with no prior dental experience and requiring dental treatment under nitrous oxide sedation who were systemically healthy were included in the study. The 5 senses (i.e. hearing, touch, smell, taste and vision) were evaluated with different materials at 4 different titration levels to evaluate the effect of nitrous oxide on the 5 senses T0: 100 % oxygen, T1: 30 % nitrous oxide, T2: 50 % nitrous oxide, T3: 100 % oxygen. RESULTS The results of the present study depicted that there is significant difference in the perception of various senses at different concentrations of nitrous oxide and also when compared to baseline values. It was observed that the patient regained the normal perception in 5 minutes after 100 % oxygen post-operatively. CONCLUSIONS Nitrous oxide is found to depress/relax one’s senses too. KEY WORDS Vision, Smell, Taste, Touch, Sound, Perception, Consciousness, Nitrous Oxide Sedation, Oxygen, Behaviour

scholarly journals Remifentanil in Combination With Propofol Is Suitable for Use in the Dental Outpatient Setting

2016 ◽  
Vol 63 (3) ◽  
pp. 116-121
Author(s):  
Makoto Maeno ◽  
Ken-ichi Fukuda ◽  
Toyoaki Sakamoto ◽  
Yoshihiko Koukita ◽  
Tatsuya Ichinohe
Keyword(s):  
Nitrous Oxide ◽  
Saline Solution ◽  
Dental Treatment ◽  
Outpatient Setting ◽  
General Anesthetic ◽  
Body Movements ◽  
Hemodynamic Changes ◽  
Ideal Agent ◽  
Index Value ◽  
The Ideal

Although several adjuncts to the general anesthetic propofol have been proposed, there is insufficient research identifying the ideal agent, and in what dosage, to combine with propofol in dental outpatient anesthesia. Here we examined the combination of remifentanil or nitrous oxide and propofol in patients with severe dental avoidance undergoing dental treatment in the outpatient setting. Eighty patients were randomized to 4 groups and administered propofol/saline solution (PS; n = 20), propofol/remifentanil 0.25 μg/kg/min (PRe-0.25; n = 20), propofol/remifentanil 0.125 μg/kg/min (PRe-0.125; n = 20), or propofol/66% nitrous oxide (PN; n = 20). During anesthesia, the bispectral index value was kept between 40 and 60. Body movements and hemodynamic changes during anesthesia, emergence, and recovery as well as anesthetic cost were compared between the combinations. Body movements were observed in all patients administered PS but in no patients administered PRe-0.25, PRe-0.125, or PN. Postoperative nausea was observed in 5 patients (25%) administered PRe-0.25 and in 1 patient (5%) administered PN. Although both PRe-0.125 and PN were useful clinically, PRe-0.125 was the least expensive combination.

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