Nitrous oxide procedural sedation in non-fasting pediatric patients undergoing minor surgery: a 12-year experience with 1,058 patients

Pasarón, Raquel; Burnweit, Cathy; Zerpa, Jeannette; Malvezzi, Leopoldo; Knight, Colin G.; Shapiro, Tina; Ramos, Carlos G.; Velis, Evelio

doi:10.1007/s00383-014-3608-5

Cited by 29 publications

(27 citation statements)

References 36 publications

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“…The level of sedation must be such that the patient remains conscious, retains protective reflexes, and is able to understand and to respond to verbal commands [ 17 ]. It may be considered as the first level in the sedation process [ 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

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

Galeotti

Bernardin

D’Antò

et al. 2016

BioMed Research International

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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.

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Section: Introductionmentioning

confidence: 99%

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

Galeotti

Bernardin

D’Antò

et al. 2016

BioMed Research International

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“… It provides a minor amnestic effect. Children who have been sedated with N 2 O often have little recollection of the painful elements of the procedure [ 14 ]. It has a long history of having an excellent safety profile with few reported cases of adverse events.…”

Section: Benefits Of N 2 O For Psamentioning

confidence: 99%

“…It provides a minor amnestic effect. Children who have been sedated with N 2 O often have little recollection of the painful elements of the procedure [ 14 ].…”

Section: Benefits Of N 2 O For Psamentioning

confidence: 99%

“…The administration of nitrous oxide is relatively safe, with few patients experiencing any adverse events. Some of the most commonly reported negative side effects of N 2 O include vomiting, nausea, dizziness, headache, tingling, and euphoria [ 14 ]. The risk of nausea and vomiting after N 2 O administration increases with the duration of sedation [ 40 ].…”

Section: Side Effectsmentioning

confidence: 99%

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Nitrous Oxide, From the Operating Room to the Emergency Department

Huang

Johnson

2016

Curr Emerg Hosp Med Rep

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“…Several observational studies found no clear association between adverse events and NPO status. [9][10][11][12]…”

Section: Pre-sedation Patient Evaluationmentioning

confidence: 99%

Procedural Sedation for Orthopedic Fracture Reductions in the Pediatric Emergency Department

Bal¹,

Hennes²

2016

cayd

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To provide an updated literature review on pediatric procedural sedation in the emergency department. Discuss patient evaluation, monitoring, indications, and contraindications of common pharmacologic agents used for procedural sedation during orthopedic fracture reductions in the pediatric emergency department. Literature search from 1995 to 2015 was conducted using MEDLINE (PubMed), CINAHL, Cochraine and EMBASE databases. Terms included; procedural sedation, fracture reduction, orthopedic reduction, fasting, monitoring, capnometry, Bispectral index and pediatric procedural sedation. We identified a total of 1268 publications covering the literature search criteria listed above. Twenty-two studies evaluated procedural sedation for reduction of closed skeletal injuries in the pediatric emergency department (eight retrospective case series, five prospective case series and nine randomized controlled clinical trials). The published literature utilized different pain assessment scales, pharmacologic agents, and satisfaction evaluation methodology. Ketamine alone or in combination with midazolam was the most common sedation agent used in the published literature. The use of procedural sedation for performing painful procedures in the pediatric emergency department is common. Ketamine and nitrous oxide are the most commonly used pharmacologic agents. Both agents have an excellent safety profile when published sedation guidelines are followed. Patient monitoring is the single most critical element for providing safe sedation in the emergency department. There are several adjuncts for providing safe and effective sedation in the emergency department including capnography, Ramsay sedation scale, Bispectral index, and aldrete score.

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Nitrous oxide procedural sedation in non-fasting pediatric patients undergoing minor surgery: a 12-year experience with 1,058 patients

Abstract: This is the longest reported study using non-anesthesiologist-administered nitrous oxide as a single-agent for minor surgical procedures. The technique provides safe sedation and excellent amnesia, allowing pain and anxiety-reduced surgery with no fasting or postoperative monitoring.

Cited by 29 publications

References 36 publications

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

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

Nitrous Oxide, From the Operating Room to the Emergency Department

Procedural Sedation for Orthopedic Fracture Reductions in the Pediatric Emergency Department

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