nitrous oxide oxygen
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2021 ◽  
Vol 76 (08) ◽  
pp. 471-476
Author(s):  
Nicoline Potgieter ◽  
Günther Streit

Behaviour management for anxious paediatric dental patients is challenging. Solutions include education and sedation. Various drugs have been used to effectively sedate paediatric patients during treatment. The aim of this study was to review literature on the sedation of paediatric patients. The study specifically looked at those reviews covering the combination of two sedation methods in case of more challenging paediatric patients. The study undertook a literature review focused on studies using nitrous oxide, Midazolam, or a combination of the two substances. An electronic search was done on EBSCOhost to source articles published from 1979 to 2019. A deeper form of sedation can be achieved for paediatric patients when using a combination of nitrous oxide, oxygen and a hypnotic agent such as Midazolam. Dealing with the anxiety levels of paediatric patients is a challenge for dental health providers. Two of the main strategies used to deal with anxious children are behaviour management and sedation. A critical review of journal articles on the use of nitrous oxide and oxygen in combination with Midazolam was therefore undertaken. The findings suggest that, in order to achieve a deeper form of sedation, the combination of nitrous oxide, oxygen and Midazolam works well to reduce discomfort, anxiety and/or pain in paediatric patients.


2021 ◽  
Vol 68 (2) ◽  
pp. 69-75
Author(s):  
Ben Kushnir ◽  
Sara Fowler ◽  
Melissa Drum ◽  
John Nusstein ◽  
Al Reader ◽  
...  

The inferior alveolar nerve block (IANB) does not always result in successful pulpal anesthesia. Nitrous oxide may increase the success of the IANB. The purpose of this investigation was to study the effect of nitrous oxide/oxygen (N2O/O2) on IANB injection pain and mandibular pulpal anesthesia in asymptomatic subjects. One hundred five asymptomatic subjects received an IANB after the administration of N2O/O2 or room air/oxygen (air/O2) at 2 separate appointments. After the IANB, subjects rated their level of pain for each phase of the injection (needle insertion, needle placement, and solution deposition) using a Heft Parker visual analog scale. Pulpal anesthesia was evaluated with an electric pulp tester for 60 minutes. The mean pain rating for all 3 injection phases showed a statistically significant reduction in pain when N2O/O2 was used compared with Air/O2 (P < .05). Odds ratios demonstrated a statistically significant increase in IANB success for the N2O/O2 group compared with the air/O2 group. N2O/O2 administration statistically decreased pain for all 3 injection phases of the IANB. In addition, nitrous oxide statistically increased the likelihood of pulpal anesthesia for posterior mandibular teeth. However, the incidence of pulpal anesthesia was not 100%.


2021 ◽  
Vol 31 (3) ◽  
pp. 433-435
Author(s):  
Kunal Gupta ◽  
Dimitrios Emmanouil ◽  
Amit Sethi

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hai-Xiang Gao ◽  
Jun-Jun Zhang ◽  
Ning Liu ◽  
Yi Wang ◽  
Chun-Xiang Ma ◽  
...  

Abstract Background The pain management of postherpetic neuralgia (PHN) remains a major challenge, with no immediate relief. Nitrous oxide/oxygen mixture has the advantages of quick analgesic effect and well-tolerated. The purpose of this study is to investigate the analgesic effect and safety of nitrous oxide/oxygen mixture in patients with PHN. Methods/design This study is a single-center, two-group (1:1), randomized, placebo-controlled, double-blind clinical trial. A total of 42 patients with postherpetic neuralgia will be recruited and randomly divided into the intervention group and the control group. The control group will receive routine treatment plus oxygen, and the intervention group will receive routine treatment plus nitrous oxide/oxygen mixture. Data collectors, patients, and clinicians are all blind to the therapy. The outcomes of each group will be monitored at baseline (T0), 5 min (T1), and 15 min (T2) after the start of the therapy and at 5 min after the end of the therapy (T3). The primary outcome measure will be the pain intensity. Secondary outcomes included physiological parameters, adverse effects, patients’ acceptance of analgesia, and satisfaction from patients. Discussion Previous studies have shown that nitrous oxide/oxygen mixture can effectively relieve cancer patients with breakthrough pain. This study will explore the analgesic effect of oxide/oxygen mixture on PHN. If beneficial to patients with PHN, it will contribute to the pain management of PHN. Trial registration Chinese Clinical Trial Register ChiCTR1900023730. Registered on 9 June 2019


Author(s):  
Monika Nagpal ◽  
Mohan Lal Khatri ◽  
Anil Gupta ◽  
Ankit Srivastava ◽  
Shalini Garg

Introduction: In-office pharmacological sedation techniques are best applied to manage an extremely fearful preschooler, especially during primary dentition or a child’s early mixed dentition period. These should be used when non pharmacological behavioural management techniques fail either due to lack of communication or in children with special care needs. Aim: To compare the efficacy of oral administrations of midazolam, ketamine, combination of midazolam-ketamine (M+K) and nitrous oxide-oxygen (N2O) inhalational sedation in achieving favorable behavioural outcome compared by using the Houpt scale in the treatment of anxious and uncooperative paediatric patients. Materials and Methods: A randomised clinical trial was conducted in the Department of Paediatric and Preventive Dentistry, SGT University, Haryana, India between September 2018 to December 2019. The study included 100 anxious children (Venham’s picture scale) aged three to five years, who required procedures under local anaesthesia administration were divided into four groups using envelop method. Each group was given either oral midazolam (M) (0.3 mg/kg) or oral ketamine (K) (3 mg/kg) or oral combination of midazolam+ketamine (M+K) (0.3 mg/kg and 2 mg/kg) or inhalational nitrous oxide-oxygen (N2O). The behaviour response of the child was recorded using the Houpt scale. The oxygen saturation level and heart rate of each patient were also recorded before, after, and during the procedure. Adverse drug reactions post-treatment was also recorded. Analysis of Variance (ANOVA), Chi-square test and Mann-Whitney U test was used for statistical analysis. Results: The study comprised of 100 anxious children (mean age was 4.1±0.5 years) requiring administration of local anaesthesia with intent to complete in-office treatment. Statistically, a significant difference was found among behaviour outcomes of four groups (p-value=0.047). Acceptable behaviour was seen best in K+M group (88%), followed by oral ketamine (K) (68%), N2O (59%), and oral midazolam (M) (52%). Adverse reactions were most commonly seen in the oral ketamine group. Conclusion: Oral M+K combination group is significantly better than oral ketamine (K), oral midazolam (M) or N2O inhalation sedation to achieve the required behaviour for dental treatment in three to five years old patients.


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