Comparative evaluation of changes in physiological and psychomotor effects in pediatric patients during extraction under different concentrations of nitrous oxide–oxygen inhalation sedation

Abstract

Introduction: Nonpharmacological behavioral management techniques are routinely used to create an environment that facilitates and builds a rapport between the child and the dentist to carry out procedures with minimal disruption. However, the discomfort associated with oral injections produces varying degrees of stress in all patients. Nitrous oxide (N2O)–oxygen (O2) inhalation sedation is one of the most widely used modalities for the management of fear and anxiety in children. Objective: The objective was to evaluate changes in physiological and psychomotor effects in pediatric patients during extraction under different concentrations of N2O–O2 inhalation sedation. Materials and Methods: A total of 300 healthy patients in the age range of 6–12 years (mean 8.9 years), who needed extraction of primary tooth, were included in the study. Pulse rate, SpO2, blood pressure (BP), and temperature were recorded at baseline, 30% N2O concentration, 50% N2O concentration, and again postoperatively. In addition, anxiety levels and neuromuscular coordination were recorded at the respective intervals. Results: The results revealed a mean decrease in pulse rate and BP from baseline and an increase in temperature and O2 saturation during the sedation procedure. The findings were statistically significant. Significant impairment of coordination and psychomotor ability was seen at each step. Anxiety had significantly reduced after the onset of sedation due to the anxiolytic effect of N2O. Conclusion: N2O–O2 inhalation sedation under different concentrations reduces the anxiety of the patient and produces adequate sedation with vital signs within normal limits along with temporary impairment of psychomotor ability and coordination.

Keywords

• flacc scale
• n2o–o2 inhalation sedation
• trieger test
• wong–baker faces rating scale