TWO METHODS OF CONSCIOUS SEDATION IN CHILDREN (ENTONOX AND MIDAZOLAM) – EVALUATION

Abstract

The aim of study was to compare coping in children with two methods of conscious sedation - inhalation nitrous oxide-oxygen mixture (N) and oral midazolam; a mixture of IV solution with syrup (M).

Methods: Parental informed consent was obtained for every sedation. Subjects were recruited from child patients referred to the Paediatric Dentistry Department, School of Dental Medicine. Inclusion criteria were ASA I, II, no medical contraindications for N or M, intake of food and liquids limitation related to sedation (N or M). Frankl behaviour rating scale (F) was recorded during an initial visit and after sedation (Outcome of Sedation Scale used for difference in F scores - OSS), presence of amnesia after sedation, type of procedure (restorations or extractions), dental status using dmft/DMFT, pain evaluation using Wong Baker Faces scale (W). Parents were asked to complete a short questionnaire after sedation. Wilcoxon sign-ranked test (p=0.05) was used to compare study groups.

Results: Altogether 129 children (66 M, mean age 5.07, 63 N, mean age 6.63) participated in the study. Satisfaction with sedation did not differ between sedation types (p = 0.60). F increased after both sedation methods. OSS for M = 0.4, N = 0.8. 61 (92.6%) parents were satisfied with the course of the sedation in M group and 60 (95.7%) parents in N group. The relationship to the dentist was changed after N (p = 0.05). There was no change in relationship to the cariogenic food N (p = 0.77), M (p = 0.86) and toothbrushing N (p = 0.48), M (p = 0.19). Reasons for sedations were not dependent on sedation type p = 0.17. Pain score was higher in M (3.6) than in N (1.8). Amnesia depended on OSS p = 0.02. 58 (91.3%) parents who would choose the same type of sedation if indicated were in N group and 49 (74.1%) in M group.

Conclusions: There were significant differences in childrens behaviour when using these two sedation methods and in a case of inhalation nitrous oxide-oxygen mixture, there was a change of relationship to the dentist. Further the presence of amnesia was associated with changes in the behaviour scale, not with the sedation method.