Risk of respiratory depression at use of nitrous oxide on individuals with cerebral palsy: a clinical trial

Fernando Martins Baeder,Dênis Clay Lopes Dos Santos,Andrea Pavanello,Maria Teresa Botti Rodrigues Santos,Daniel Furtado Silva,Antônio Francisco David,Ana Carolina Lyra De Albuquerque

doi:10.33448/rsd-v10i13.20774

Fernando Martins Baeder, Dênis Clay Lopes Dos Santos + Show 5 more

Open Access

https://doi.org/10.33448/rsd-v10i13.20774

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Abstract

The dental care for individuals with cerebral palsy (CP) often result in the referral of patients for general anesthesia. Conscious sedation with nitrous oxide (N2O) could be an alternative resource, from a behavioral and physiological point of view, and could favor dental care in an outpatient setting. This study aimed to evaluate the influence of conscious sedation with N2O on respiratory rate (RR) and oxygen saturation (SpO2) in the dental treatment of individuals with CP. Seventy-seven patients with CP, over 3 years old, regardless of gender and ethnicity, were evaluated with the measurement of N2O titration, RR and SpO2 in four moments: initial, 5 minutes after sedation, 10 minutes after anesthesia and 5 minutes after removal of the N2O. Student's t test and ANOVA F were used, with a significance level of 5%. The variation in N2O titration did not generate significant variation in RR (p = 0.122). There was a significant difference in SpO2 between T1 and other times. It can be said that conscious sedation is not influenced by N2O titration, does not cause respiratory depression or any clinically significant change in SpO2, confirming the safety of use in an outpatient setting.

Highlights

Cerebral palsy (CP) is a disabling condition that has a well-recognized pattern of neurological development, which manifest at the beginning of brain development and persist throughout the individual’s life (Wimalasundera & Stevenson, 2016)
The results for the categorical variables are presented in tables of absolute and relative frequencies, while continuous variables are presented as position statistics and scale
Analysis of the results could suggest that sedation with nitrous oxide is a simple, safe and effective process when used as an auxiliary resource in the dental care of individuals with CP

Summary

Introduction

Cerebral palsy (CP) is a disabling condition that has a well-recognized pattern of neurological development, which manifest at the beginning of brain development and persist throughout the individual’s life (Wimalasundera & Stevenson, 2016). In some cases, compromised function of the upper limbs can hinder the brushing movement, facilitating the accumulation of dental biofilm, which favors a higher prevalence of oral disease and the need for differentiated dental care (Ahmad et al, 2020; Cardona-Soria et al, 2020; Sedky, 2018). These factors often result in the referral of patients for general anesthesia during dental treatment, together with other individual medical complications (Ashley, Chaudhary & Lourenço-Matharu, 2018). Conscious sedation with nitrous oxide (N2O) could be an alternative resource for such patients, from a behavioral and physiological point of view, and could favor dental care in an outpatient setting (Ashley, Chaudhary & Lourenço-Matharu, 2018, Galeotti et al, 2016)

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