1 429 cases treated with nitrous oxide inhalation sedation in dental clinic: a retrospective study / 口腔疾病防治

Objective@#The use and effect of nitrous oxide sedation techniques in oral clinics were analyzed retrospectively.@*Methods@#Patients who were treated with nitrous oxide inhalation sedation in the clinic of the Affiliated Stomatological Hospital of Guangzhou Medical University from January 1, 2016, to December 30, 2018, were examined. Age and gender of the patients, dental treatments involved, reasons for nitrous oxide inhalation, sedative effects and adverse reactions were compiled.@* Results @#A total of 1 429 cases were examined, comprising 587 males and 842 females, and the average age was 32.64±16.34 years old. Among the patients who underwent nitrous oxide inhalation sedation in the oral clinic, 79.98% needed tooth extraction, and 79.50% had a dental fear of procedures. The patients were divided into following 7 age groups: 5-15 years old, 16-25 years old, 26-35 years old, 36-45 years old, 46-55 years old, 56-65 years old and > 65 years old. The sedation satisfaction rate of the 5-15-year-old group was 45.71%, and the sedation satisfaction rate of the other 6 age groups was 90.83%- 96.20% (P < 0.001). The incidence of total adverse reactions was 5.39%; the incidence was higher in females than in males, and the incidence was higher in the 16-25 age group than in the other age groups (P < 0.05). The most frequent adverse reaction was vertigo (81.82%).@*Conclusion@# Among the four common oral outpatient treatment programs including the extraction of teeth, dental implants, pulp treatment and periodontal treatment, patients undergoing inhalation sedation of nitrous oxide in the dental extraction most. The most common reason for requiring sedation is dental fear, and the sedative effect of the 5-15-year-old group was significantly worse than that of the other age groups. The incidence of adverse reactions of nitrous oxide sedation was low and manageable.

Blood Gas Analysis of Respiratory Depression during Sevoflurane Inhalation Induction for General Anesthesia in the Disabled Patients / 대한소아치과학회지

Tidal volume by sevoflurane in small amounts is stable due to the increase in the breathing rate. But alveolus ventilation decreases due to sevoflurane as the degree of sedation increases; this ultimately causes PaCO2 to rise. The occurrence of suppression of breath increases the risk of severe hypoxia and hypercapnia in deeply sedated patients with disabilities. Sevoflurane inhalation anesthesia has a number of risks and may have unexpected problems with hemodynamic changes depending on the underlying state of the body. This study was conducted to examine the stability of internal acid-base system caused by respiratory depression occurring when patients with disabilities are induced by sevoflurane.Anesthetic induction was carried out by placing a mask on top of the patient's face and through voluntary breathing with 4 vol% of sevoflurane, 4 L/min of nitrous oxide, and 4 L/min of oxygen. After the patient's loss of consciousness and muscle relaxation, IV line was inserted by an expert and intravenous blood gas was analyzed by extracting blood from vein.In a deeply sedated state, the average amount of pH of the entire patients was measured as 7.36 ± 0.06. The average amount of PvCO₂ of the entire patients was measured as 48.8 ± 8.50 mmHg. The average amount of HCO₃₋ of the entire patients was measured as 27.2 ± 3.0 mmol/L.In conclusion, in dental treatment of patients with disabilities, the internal acid base response to inhalation sedation using sevoflurane is relatively stable.

Sedação inalatória com óxido nitroso/oxigênio: uma opção eficaz para pacientes odontofóbicos / Nitrous oxide/oxygen inhalation sedation: an effective option for odontophobic patients

O medo é o principal obstáculo para o atendimento odontológico seguro e de sucesso. A utilização da sedação inalatória vem se mostrando eficaz para o controle de comportamento destes pacientes. Entretanto, no Brasil, ainda poucos cirurgiões-dentistas são habilitados e lançam mão desta ferramenta. O objetivo deste relato é demonstrar um caso de paciente odontofóbico atendido com sucesso através da sedação inalatória. Esta técnica é eficaz para o tratamento odontológico de pacientes odontofóbicos, permitindo a colaboração do paciente e diminuindo os riscos de emergências médicas.

The fear is the main obstacle to a safe and successful dental care. The use of inhalation sedation has proved effective for controlling behavior of these patients. However, in Brazil, yet few dentists are enabled, and lay hold of this tool. The objective of this report is to demonstrate a case of odontophobia patient treated successfully by inhalation sedation. This technique is effective for dental treatment of odontophobic patients, allowing the patient’s collaboration and decreasing the risk of medical emergencies.