Sedative Agents in Minor Paediatric Oral Surgical ProceduresA Narrative Review

Abstract

Sedation in pediatric dentistry reduces anxiety during surgical procedures and also helps cope with very stressful events encountered during dental treatment. Various sedative agents like Nitrous oxide, diazepam, midazolam, Ketamine, propofol, fentanyl, and dexmedetomidine have been administered through several sedation routes including oral, nasal, inhalation, intramuscular, and sub-mucosal to attain active sedation. However, it is evident that the sesedative drugs also have the prospective to causelethal complications. Aim: The present review was carried out to brief the clinical aspects of various sedative agents currently available in pediatric practices based on the existing literature with special emphasis on their role in minor pediatric oral surgical procedures. Discussion: Nitrous oxide is frequently used in combination with complextime-consuming procedures and dental extractions, particularly for young and anxious patients undergoing orthodontic extractions. Fentanyl decreases pain and anxiety but causes respiratory distress. Oral ketamine is a potent dissociative drug often combined with midazolam produces excellent analgesic and sedative effects. None the less, the most common combinations include sedatives with ketamine/opioids or dexmedetomidine to maintain the airway reflexes if given in small doses with precautions. Sometimes a combination of inhaled gases especially short-acting sevoflurane along with Diazepam is favored. Conclusion: Within the limitation, it is evident that a clear understanding of the proper selection of sedative agents, awareness of the intended level of sedation or route of drug administration, and knowledge of adverse responses during and after sedation are essential to achieve appropriate sedation levels during minor oral surgical procedures.