La sedazione cosciente inalatoria con protossido d’azoto e ossigeno in odontoiatria

Objectives

To examine the existing possibilities of controlling anxiety in the dental office practice. While pain control is not a problem with the current techniques of regional anesthesia and with the modern local anesthetics, control anxiety and fear is still a limit to the treatment of categories of patients such as children, disabled, psychiatric patients however, who have a strong emotional component. The use of sedation and anxiolysis also reduces the risk of medical complications in dental treatment of patients “at risk” for systemic diseases.

Materials and methods

The technique of inhalation analgesia and sedation with nitrous oxide and oxygen is described in detail, after analyzing the current classification of sedation: pharmacokinetics and toxicity of two gases, indications and contraindications, operative technique in the adult and pediatric dental patient using dedicated equipment, possible adverse effects and complications. The scientific literature on the safety aspects of the methodology and forensic in dentistry is then revised.

Results

The review confirms the efficacy and the absolute safety of the sedative technique inhaled nitrous oxide and oxygen, provided that it is not associated with other hypnotic or sedative drugs. The dental practitioner is considered suitable for inhaled conscious sedation in outpatient environment, even at a higher rate of 50% nitrous oxide. Although the technique does not present risks of cardiovascular and respiratory, current legislation requires dental practitioner adequate training in cardiopulmonary resuscitation (BLS-D).

Conclusions

The inhaled sedation with nitrous oxide and oxygen sedation technique is considered the first choice in dental outpatient environment, as it ensures fast action and equally rapid elimination of the effects, safety and clinical efficacy.