ABOUT SEDATION

 

Nitrous Oxide or “Laughing Gas”

Nitrous oxide (or laughing gas) is a colorless and virtually odorless blend of 2 gases with a faint, sweet smell. When inhaled, it is absorbed by the body and has a calming effect. It is an effective agent for lessening pain and anxiety. It generally works well in children who have some degree of cooperation. Most children are enthusiastic about the administration of nitrous oxide/oxygen; they often report feeling happy or feel like they are ‘floating or flying’. If your child is worried by the sights, sounds or sensations of dental treatment, he or she may respond more positively with its use. For some patients, however, the feeling of “losing control” may be troubling; claustrophobic patients may find the nasal hood confining and unpleasant. Children who have severe anxiety, nasal congestion, extensive treatment needs or discomfort wearing a nasal mask will not benefit from nitrous oxide/oxygen.

Nitrous oxide takes effect and wears off rapidly (2-3 minutes) with normal breathing. Your child will have minimal impairment of any reflexes. Since the gas effects wear off almost immediately after it is turned off, your child can go home as soon as he/she is ready.

Acute and chronic adverse effects to nitrous oxide are rare. It is non-addictive. It is mild, easily taken and your child remains fully conscious. The most common side effects are nausea and vomiting. These are usually prevented by following the pre-operative instructions given to you prior to the appointment.

The objectives of nitrous oxide/oxygen sedation are:

  • To reduce or eliminate pain and/or anxiety;
  • To reduce the unpleasantness associated with dental treatment;
  • To enhance communication and patient cooperation;
  • To increase tolerance for longer appointments;
  • To reduce gagging.
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    Oral Sedation

    Goals of conscious sedation

    The goals of sedation in the pediatric patient for diagnostic and therapeutic procedures are as follows:

    • to guard the patient’s safety and welfare
    • to minimize physical discomfort and pain
    • to control anxiety, minimize psychological trauma, and maximize the potential for amnesia
    • to control behavior and/or movement so as to allow the safe completion of the procedure
    • to return the patient to a state in which safe discharge from medical supervision, as determined by recognized criteria, is possible.

     
    The Sedatives

    We may use different sedative agents to sedate your child depending on the individual needs of your child. These may include any one or a combination of the following medications:

    Possible side effects of sedation

    • Midazolam (Versed)
    • Diazepam (Valium)
    • Meperidine (Demerol)
    • Hydroxyzine (Atarax)

    Not all children react the same way to the medication. This is affected by their individual physiology, temperament and anxiety level. Some minor side effects include sleepiness, vomiting, dry mouth, grumpiness, hyperactivity and anger. These are reversible when the medication wears off in a few hours. More severe side effects may include allergic reaction or respiratory and/or central nervous system depression. Our doctor will tailor the dose of the medication according to your child’s weight and subsequently by the response of your child at the first procedural appointment.

     

    General Anesthesia

    Children who have severe anxiety, are too young to cooperate, have extensive dental treatment needs or have certain medical conditions are candidates for dental treatment under a general anesthetic. Patients requiring dental care for whom the use of general anesthesia may protect the developing psyche and/or reduce medical risks are also indicated.

    These services will be provided at a private, out-patient facility with a licensed medical anesthesiologist and trained surgical team. We have privileges at the following location:

    Langley Surgical Centre

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