The physiological effects of supplemental oxygen versus nitrous oxide/oxygen during conscious sedation of pediatric dental patients.

Resident: Adam J. Bottrill
Date: 02APR10
Region: Providence
Article title: The physiological effects of supplemental oxygen versus nitrous oxide/oxygen during conscious sedation of pediatric dental patients.
Author(s): Leelataweewud, Pattarawadee et al.
Journal: Pediatric Dentistry
Page #s: 125-133
Year: 22:2, 2000
Major topic: Nitrous oxide use
Minor topic(s): Behavior management
Type of Article: Research article

Main Purpose: The study was performed to compare the effects of N2O/O2 vs O2 as adjuncts to an oral narcotics regimen for pediatric conscious sedation.

Overview of method of research: Randomized, double-blind crossover design

Key points in the article discussion:

I. Overview
A. 19 children sedated with chloral hydrate, iniperidine and hydroxyzine pamoate for two apts.
B. Randomly given O2 at one visit and N2O/O2 for the other.
C. Parameters: PR, RR, SpO2, ETCO2\
D. Procedures: mouth prop, anesthesia, rubber dam clamp, tooth prep,
E. Sedation success measured on scal of 0-3… 0=excellent, 3=aborted

II. Conclusions:
A. Although there were no differences in the physiological parameters for PR or SpO2, there was a small increase in RR in the N2O/O2 group.
B. N2O/O2 did NOT increase the risk of desaturation but did increase the frequency7 of desaturation events.
C. N2O/O2 deepened the level of sedation with this narcotic sedation regimen.
D. When N2O/O2 is used with this narcotics sedation regimen, child patients should be monitored with heightened vigilance and monitoring with capnography is recommended.

Assessment of article: Hmmmm…. Even though I’m only a PGY1… I could have saved Pattarawadee the time and effort of a fully-blown randomized, double-blinded study!!…. One word…Shenanigans.