We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
ADVANCED PAEDIATRIC CONSCIOUS SEDATION: AN ALTERNATIVE TO DENTAL GENERAL ANAESTHETIC IN THE UK.
- Authors
Hand, Darren; Averley, Paul; Lyne, John; Girdler, Nick
- Abstract
Background. Child dental anxiety is widespread, and it is not always possible to treat children using traditional methods such as behavioural management, local anaesthesia and even relative analgesia. In such cases a dental general anaesthetic (DGA) is the only option available to facilitate dental treatment in anxious children. Aim. This study describes an advanced conscious sedation protocol which allows invasive treatment to be carried out in anxious children. It incorporates the use of titrated intravenous midazolam and fentanyl and inhalation agents, sevoflurane and nitrous oxide/oxygen, which is administered by a Consultant Anaesthetist. The aim is to produce an evidence- based study which can offer a sedation technique as a safe and effective alternative to a DGA. Study Design. Retrospective audit. Method. 267 clinical records were audited retrospectively from a specialist sedation- based clinic, for children aged 5-15 years old. The subjects all underwent invasive dental procedures with this technique between August and November 2008 as an alternative to a DGA. Results. 262/267 (98%) of the subjects were treated safely and successfully and without the loss of verbal communication using this technique. This included many treatments requiring four quadrant dentistry, with both restorations and extractions as necessary being carried out in one visit. 5 subjects (2%) did not tolerate treatment and had to be referred for a DGA. No medical emergencies occurred. Conclusions. Based on the evidence for this group of patients, this advanced conscious sedation technique, offers a safe and effective alternative to DGA. This technique must be carried out in an appropriate environment by an appropriately trained and experienced team who are able to comply with the recommendations for "alternative" sedation techniques.
- Subjects
UNITED Kingdom; CONSCIOUS sedation; DENTAL anesthesia; ANXIETY in children; CHILDREN'S dental care
- Publication
SAAD Digest, 2011, Vol 27, p24
- ISSN
0049-1160
- Publication type
Article