Inhalation sedation

Inhalation sedation is a form of conscious sedation where an inhaled drug should:

The following are possible uses for conscious sedation "dental anxiety and phobia, a need for prolonged or traumatic dental procedures, medical conditions potentially aggravated by stress (such as ischaemic heard disease, hypertension, asthma and epilepsy), medical or behavioural conditions affecting a patient's ability to cooperate, special care requirements".

Complications arising in inhalation sedation are rare and are termed as are those which require intervention in order to correct adverse physiological consequences that can inadvertently accompany the sedation technique. They include "over-sedation, respiratory depression/apnoea, unconscious patient, airway obstruction, vomiting, idiosyncratic responses, delayed recovery and failure of conscious sedation".

Few absolute contraindications exist, however, "relative contraindications are important and can only be considered following a full assessment." They include:

On a visit prior to the treatment session, a full assessment is carried out in order to deduce the need for sedation and the technique most suited to the individual patient. This comprises of a detailed record of the patient's history and a thorough examination:

A medical, dental and social history taken takes into account the patient’s age, state of health, social circumstances, drug history and any special needs, in order to determine that the conscious sedation technique chosen is the most appropriate to enable successful treatment outcomes for each individual.

An examination takes into account the patient's general appearance, skin colour, pulse, blood pressure and respiration rates.

It is recommended that "only patients in ASA classes I and II should normally be considered suitable for sedation in the primary care dental setting" and that "patients in ASA class III or IV should be referred to an appropriate secondary care (i.e. hospital) establishment which has critical care facilities."

In UK, machines used for the administration of inhalation sedation should follow the British Standards and be well-maintained according to the manufacturer's guidance.

Equipment used for inhalation sedation for dentistry include:

Oxygen fail safe mechanism is the most important safety feature of the equipment used in inhalation sedation. Nitrous oxide flow is only allowed via an opened valve when there is flow of oxygen to the system. In any circumstances when oxygen flow is less than 30%, nitrous oxide stops flowing. This prevents the potential delivery of 100% nitrous oxide and it becomes a standard on every sedation unit made today.

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Wikipedia