Abstract
IntroductionIndividuals with cerebral palsy (CP) often present with oral alterations that impact oral health and require dental treatment.AimThis study aimed to evaluate the use of conscious sedation with nitrous oxide (N2O) to control stress during dental treatment in individuals with CP using as parameters: Venham score (VS), heart rate (HR), and respiratory rate (RR).Materials and methodsA total of 77 CP patients >3 years of age with a mean age of 11.8 (± 6.4) years were evaluated in a rehabilitation center. Stress control was measured at the following time points: T1 (presedation), T2 (induction), T3 (sedated patient), and T4 (end). Student’s t-test, the Chi-squared test, analysis of variance (ANOVA), and the McNemar test were used. The significance level was 5%.ResultsSedation ranged between 10 and 60% N2O, with an average of 35.6% (± 10.4). The RR did not vary among the times (p = 0.12). The HR and VS varied significantly between times (p < 0.001), as significantly higher values of HR were observed at T1.ConclusionConscious sedation with N2O during dental care controls stress in CP patients, as verified by a decrease in HR, and does not promote respiratory depression. Higher concentrations of N2O are recommended for CP patients with tachycardia.Clinical significanceSedation modifies behavior during dental procedures, facilitating patient collaboration.How to cite this article: Baeder FM, Silva DF, de Albuquerque ACL, Santos MTBR. Conscious Sedation with Nitrous Oxide to control Stress during Dental Treatment in Patients with Cerebral Palsy: An Experimental Clinical Trial. Int J Clin Pediatr Dent 2017;10(4):384-390.
Highlights
Individuals with cerebral palsy (CP) often present with oral alterations that impact oral health and require dental treatment
Higher concentrations of N2O are recommended for CP patients with tachycardia
Due to the lack of studies in the literature regarding the use of conscious sedation with N2O for dental care in individuals with CP, the objective of this study was to evaluate its use with respect to stress control during dental care in individuals with CP, using the following physiological and behavioral parameters: heart rate (HR), respiratory rate (RR), and Venham score (VS)
Summary
Individuals with cerebral palsy (CP) often present with oral alterations that impact oral health and require dental treatment. Cerebral palsy is a disabling condition related to neurodevelopment. The CP causes severe motor impairment, which when coupled with associated conditions, such as intellectual disability results in reduced intraoral self-cleaning function. The CP generates abnormal involuntary movements of facial and mastication-associated muscles, as well as oral pathological reflexes that negatively impact oral health. Upper limb involvement may complicate the movements required for brushing, facilitating biofilm accumulation and fostering the increased prevalence of oral diseases, heightening the need for dental care.[1,2,3,4,5]. From both a physiological and a behavioral perspective, conscious sedation with N2O may be an alternative resource for patients who prefer dental care in an outpatient setting.[8,9] Due to the lack of studies in the literature regarding the use of conscious sedation with N2O for dental care in individuals with CP, the objective of this study was to evaluate its use with respect to stress control during dental care in individuals with CP, using the following physiological and behavioral parameters: HR, RR, and VS
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