CONSCIOUS SEDATION IN OUTPA TIENT PRACTICE – EVA LUATION,IMPACTON CHILDREN

Abstract

Aim: The aim of this pilot 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: Ethical approval for the study and parental informed consent were obtained. Subjects were recruited from 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). The sedation type was chosen with respect to indications and contraindications in EAPD guidelines. The following variables were recorded: Frankl behaviour rating scale (F) 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 and pain evaluation using the 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 significantly 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 cariogenic food in the group N (p = 0.77), M (p = 0.86) and tooth-brushing 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: A significant improvement in children´s behaviour was found after both sedation methods. In the case of N inhalation the children’s attitude to dentist improved. The presence of amnesia was related to changes in the behaviour scale, not to the sedation method.