Journal of Prevention and Treatment for Stomatological Diseases ›› 2019, Vol. 27 ›› Issue (5): 304-308.doi: 10.12016/j.issn.2096-1456.2019.05.006

• Cinical Study • Previous Articles     Next Articles

Sedative efficacy of nitrous oxide combined with midazolam in extraction of impacted supernumerary teeth in children

SHU Huang,WANG Ji,CHEN Chanchan,KUANG Yiyuan,DING Guicong   

  1. Department of Stomatology, Shenzhen Children’s Hospital, Shenzhen 518026, China
  • Received:2018-10-21 Revised:2018-10-29 Online:2019-05-20 Published:2019-05-20
  • Contact: Huang SHU

Abstract:

Objective To study the sedative efficacy and safety of nitrous oxide (N2O ) inhalation combined with oral midazolam in children with impacted supernumerary teeth for extraction under sedation and to provide a reference for the selection of anesthetic methods for children undergoing impacted teeth extraction.Methods Sixty patients aged 5-10 years with maxillary impacted supernumerary teeth were randomly divided into three groups, with 20 in each group, as follows: the N2O group: N2O inhalation sedation before the operation; the midazolam group: oral midazolam sedation before the operation; the combination group: N2O inhalation combined with oral midazolam sedation before the operation. Sedation was performed before extraction under local anesthesia. The Ramsay sedation effect, Houpt behavioral score and incidence of adverse reactions were evaluated after the operation. Results The Ramsay sedation scale score was significantly higher in the combination group (2.75 ± 0.55) than in the N2O group (2.30 ± 0.47) and the midazolam group (2.40 ± 0.50) (P <0.05). Similarly, the Houpt behavioral rating scale score was significantly higher in the combination group (5.25 ± 0.64) than in the N2O group (4.70 ± 0.73) and the midazolam group (4.80 ± 0.69) (P <0.05). The adverse reaction rate was lower in the combination group (5%) than in the N2O group (10%) and the midazolam group (10%), but the difference was not significant (χ2=0.436, p=0.804). Conclusion N2O inhalation combined with oral midazolam sedation in the extraction of impacted supernumerary teeth in children can significantly improve the sedative and therapeutic efficacy and is a safe and effective sedation method.

Key words: Conscious sedation, N2O, Midazolam, Children, Dental fear, Impacted supernumerary tooth, Tooth extraction, Painless technique

CLC Number: 

  • R78

Table 1

Ramsay sedation scale"

分级评分Ramsay镇静分级表现
1清醒,烦躁不安
2清醒,安静合作
3欲睡,仅对指令有反应
4入睡,对呼唤反应敏捷
5入睡,对呼唤反应迟钝
6沉睡,难以唤醒

Table 2

Houpt behavioral rating scale"

分级评分Houpt行为量表分级表现
1失败:治疗过程根本无法进行
2较差:治疗过程被打断,部分治疗完成
3尚可:治疗过程被打断,最终治疗得以完成
4好:治疗过程虽困难但得以(不间断)完成
5很好:治疗过程只有轻微的哭闹和抵抗动作
6极好:治疗过程顺利,没有哭闹也没有反抗

Table 3

Comparision of general physiological indexes among the three groups $\bar{x}$± s"

组别男/女(例)年龄(岁)体重(kg)
笑气组13/76.63 ± 1.4622.67 ± 4.07
咪达唑仑组11/96.72 ± 1.5321.58 ± 4.22
联合组14/66.91 ± 1.5523.34 ± 4.21
F/χ21.0050.1530.893
p0.6050.8590.415

Table 4

Comparison of the Ramsay sedation scale score among the three groups"

组别评分(例)平均分
($\bar{x}± S$)
1分2分3分4分5分6分
笑气组(n=20)01460002.30 ± 0.471)
咪达唑仑组(n=20)01361002.40 ± 0.501)
联合组(n=20)05150002.75 ± 0.55

Table 5

Comparison of the Houpt behavioral rating scale score among the three groups"

组别评分(例)平均分
($\bar{x}± S$)
1分2分3分4分5分6分
笑气组(n=20)00231414.70 ± 0.731)
咪达唑仑组(n=20)00141324.80 ± 0.691)
联合组(n=20)00021175.25 ± 0.64

Table 6

Comparison of the adverse reaction rate among the three groups"

组别烦躁恶心嗝逆嗜睡合计发生率(%)
笑气组(n=20)11210
咪达唑仑组(n=20)11210
联合组(n=20)115
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