Pediatric Dental Sedation Practice: Evolution and Current State-of-the-Art

Mittal, Nidhi

doi:10.5005/jp-journals-10028-1119

Cited by 7 publications

(7 citation statements)

References 41 publications

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“…Also, previous authors [16][17][18] employed this agent for moderate sedation while we targeted deep sedation. We targeted deep sedation instead of moderate sedation as subjects were young, i.e., 2-6 years old and for this age group levels of sedation consistent with deep sedation are considered to be more reliable [1,26]. One fact that merits discussion here is the technique of administration of dexmedetomidine.…”

Section: Discussionmentioning

confidence: 99%

“…A plethora of sedative agents [1] have been in use in pediatric dental settings i.e. midazolam, ketamine, propofol, chloral hydrate, promethazine, hydroxyzine, nitrous oxide and sevoflurane.…”

Section: Introductionmentioning

confidence: 99%

“…midazolam, ketamine, propofol, chloral hydrate, promethazine, hydroxyzine, nitrous oxide and sevoflurane. Each of these has its own sets of limitations [1]. Despite the voluminous literature, the search for efficient and safest sedative agent is yet in its 'ongoing phase' [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

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Dexmedetomidine: A Preliminary Exploration of its Safety and Efficacy in Pediatric Dental Setting

Mittal¹,

Srivastava²,

Haider³

2015

J Anesth Clin Res

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Objective: To report on safety and efficacy of intravenous usage of Dexmedetomidine for endodontic intervention in young and anxious pediatric patients. Methods:This prospective pilot investigation enrolled 10 healthy ASA status I, 2-6 year old children who were anxious (Venham's score ≥ 4) and were scheduled to undergo primary molar pulpectomy under sedation. Sedation induction was done with 1 mg/kg of propofol bolus followed by 0.2-0.8 µg/kg of dexmedetomidine infusion for maintenance. Sedation was titrated to achieve Houpt's overall behavior score of ≥ 4. In case of insufficient sedation, rescue propofol boluses (1 mg/kg) were administered. Vitals were monitored every 5 minutes and recovery was evaluated using Alderete Modified Post Anesthesia Discharge Scoring System. Adverse events, i.e., ≥ ± 20% baseline fluctuations in vital signs, tachycardia, bradycardia, apnea, desaturation, stridor and/or laryngospasm were recorded. Results:The procedure was successfully completed in all of the subjects with the current sedation regime as per the study protocol. Rescue propofol boluses were needed in 8 subjects. No untoward fluctuations in vital signs or adverse events were reported in either intra-operative phase or post-operatively. Conclusion:Intravenous Dexmedetomidine is safe and efficient sedative for endodontic intervention in young and anxious pediatric patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Dexmedetomidine: A Preliminary Exploration of its Safety and Efficacy in Pediatric Dental Setting

Mittal¹,

Srivastava²,

Haider³

2015

J Anesth Clin Res

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“…The fact that phenothiazines do not cause unconsciousness, respiratory and circulatory system depression and addiction at high doses are two important differences of this group of drugs [12]. Phenothiazines are often used in combination with agents such as meperidine, chloral hydrate, ketamine [27]. The most commonly reported side reactions are dry mouth, blurred vision, mild hypotension, darkening of bronchial secretions.…”

Section: Promethazinementioning

confidence: 99%

The drugs and application methods in dental sedation

Öznurhan¹,

Derdiyok²

2020

J Dent Res Pract

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Sedation and general anaesthesia is indicated when routine dental treatments cannot be performed due to fear and anxiety in dentistry. The agents selected for sedation are administered by different routes such as inhalation, oral, intramuscular (IM), intravenous (IV), intranasal (IN), sublingual (SL) and rectal. Each of these routes of administration has the potential to produce sedation when the appropriate agent is selected. In this article, it is aimed to give information about sedation administration routes and drugs used in sedation.

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“…This situation tends to worsen when the intervention is urgently required. 3 Thus, the use of pharmacological techniques like general anesthesia and conscious sedation is warranted in such circumstances.…”

Section: Introductionmentioning

confidence: 99%

Amnesic potency of nitrous oxide at various titration levels

Singh¹,

Jain²,

Jain³

et al. 2023

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Introduction: Dental Treatment for an anxious child has always been a challenge to the pediatric dentist. Nitrous oxide has been documented as a safe and effective pharmacological mean of behaviour management which results in anxiolytic and analgesic effects along with slight amnesic effect. The objective of the study is to evaluate the amnesic effects of nitrous oxide during treatment at 30% and 50% concentrations of nitrous oxide and after 100% oxygen for 3 minutes. Materials and method: 30 Healthy Children (ASA I) of age group 7-12 years undergoing extraction were included in the study. Amnesic effects were evaluated visually by showing various cartoon pictures before the start of the treatment (A1) and subsequently asking the child to recognise them after 30% (A2), 50% (A3) nitrous oxide and after 100% oxygen (A4). Results: Nitrous oxide showed amnesic effects at various titration levels. Discussion: Any invasive dental intervention makes even a cooperative child uncooperative in the subsequent visits. However, any substance having amnesic effect results in no negative memory of the painful procedure performed.Nitrous oxide seems to be promising as a safe and potent amnesic agent. Conclusion: Nitrous oxide shows amnesic effects which can be helpful as it won’t let the child create any traumatic memory of the treatment.

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Pediatric Dental Sedation Practice: Evolution and Current State-of-the-Art

Cited by 7 publications

References 41 publications

Dexmedetomidine: A Preliminary Exploration of its Safety and Efficacy in Pediatric Dental Setting

Dexmedetomidine: A Preliminary Exploration of its Safety and Efficacy in Pediatric Dental Setting

The drugs and application methods in dental sedation

Amnesic potency of nitrous oxide at various titration levels

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