SAAD digest
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The aim of this prospective pragmatic audit was to investigate the level of consciousness experienced by children requiring conscious sedation in a primary care sedation service, using an 'alternative technique' to avoid referral to hospital for general anaesthesia. This technique was only applied to children who were unable to accept treatment with the use of standard inhalation sedation. The technique involved titrated inhaled oxygen and nitrous oxide and titrated sevoflurane with intravenous fentanyl and titrated midazolam. ⋯ Due to the fine control this technique offers, the duration of this level of consciousness was for mostly less than a minute and no more than five minutes. No children became unresponsive. The results of this audit demonstrate that the technique meets current standards and guidelines for 'alternative' conscious sedation, with a wide margin of safety and the rendering of loss of consciousness unlikely. 99% of patients who would otherwise have required general anaesthetic for dental treatment successfully completed their treatment using this technique.
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To determine baseline data in relation to the extraction of first permanent molar teeth during nitrous oxide/oxygen inhalation sedation sessions within the hospital dental service. ⋯ Extraction of first permanent molar teeth can be successfully achieved using nitrous oxide/oxygen inhalation sedation.
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There is a lot of controversy around the subject of sedation for children. There are many sedative agents capable of providing successful results but there are also issues regarding their safe use on a regular basis. Guidelines do exist but sometimes there is leeway for different, individual interpretations. ⋯ An e-questionnaire was used and results varied. The preferred sedation type was inhalational sedation and the guidelines most dentists agreed with came from the GDC. Further research is definitely required in this field.