Conscious sedation
a backup resource for providing dental care to uncooperative children
Keywords:
Nitrous oxide, Conscious sedation, Dental anxietyAbstract
Na prática clínica, existem muitas crianças imaturas e ansiosas ou pacientes com comportamento físico e/ou metal que não cooperam durante o tratamento odontológico. Como alternativa para o manejo desses pacientes utiliza-se a sedação consciente através da pré-medicação ou sedação com o óxido nitroso/ oxigênio. Essas técnicas, quando empregadas de maneira adequada, são válidas e seguras, obtendo-se ótimos resultados principalmente com crianças. Desta forma, o objetivo deste estudo é relatar os tipos de sedação conscientes mais utilizados em odontopediatria, como uma alternativa no tratamento odontológico de crianças com comportamento difícil.
Downloads
References
Bausells J. Odontopediatria procedimentos clínicos. In: Zuanon ACC, Hebling J, Bausells J. Medidas preventivas. São Paulo: Premier; 1997. p.45-53.
Corrêa MSNP. Odontopediatria na primeira infância. In: Corrêa MSNP, Maia MES, Sanglard- Peixoto LF. Abordagem do comportamento para o atendimento odontopediátrico. 2ª ed. São Paulo: Santos; 2005. p.187-202.
Juarez-López L, Saavedra-García M, Ramírez- González G. Estudio comparativo entre dos esquemas de sedación em pacientes odontopediátricos. Bol Méd Hosp Infant Mex.1998; 55:443-51.
American Dental Association. Guidelines for the use of conscious sedation, deep sedation and general anesthesia for dentists. Disponível em: http://www.ada.org.2007.
Alderson PJ, Lerman J. Oral premedicacion for pediatric ambulatory anaesthesia: a comparison of midazolam and ketamine. Can J Anaesth. 1994; 41:221-6.
Brandt SK, Bugg JL. Problems of medication with the pediatric patients. Dent Clin North Am.1984; 28:563-79.
Guedes-Pinto AC, Issáo M. Manual de odontopediatria. In: Conduta em relação à criança para tratamento odontopediátrico. 9ª ed. São Paulo: Pancast; 1994. p.22-43.
Haas DA. Oral anf inhalation conscious sedation. Dental Clin North Am. 1999; 43:341-59.
9. Nora FS, Fortis EA. Influência dos fármacos utilizados na sedação, na indução e manutenção quanto a recuperação da anestesia. Rev Bras Anestesiol. 2000; 50:141-8.
Hobbs WR, Rall W, Verdoorn TA. Hipnóticos e sedatives: etanol. In: Hardman JG, Limbird LE, Molinoff PB, Ruddon RW, Gilman AG. As bases farmacológicas de terapêutica. Rio de Janeiro: Guanabara; 1996. p.264-89.
Kato RM. Sedação, analgesia e bloqueio neuromuscular em UTI pediátrica. Pediatr Mod. 1998; 34:481-520.
Clark CO, Nguyen H, Phillips PK. Anxiolysis with oral midazolan in pediatric patients undergoing dermatologic surgical procedures. J Am Acad Dermatol. 2001; 45:105-8.
Folayan MOL, Faponle A, Lamikanra A. A review of the harmacological approach to the management of dental anxiety in children. Int J Paediatr Dent. 2002; 12:347-54.
Malamed L. The benzodiazepines: a pharmacological overviem. Acta Anaestesiol Scand. 1987; 32:27-30.
Giovanniti JAJr. Regimens for pediatric sedation. Comped Contin Educ Dent. 1993; 14:1002-12.
Nathan EJ. Managing behavior of precooperative children. Dent Clin North Am. 1995; 39:789-816.
Becker DE. Pharmacological considerations for conscious sedation: clinical applications of receptor funcion. Anesth Prog. 1991; 38:33-8.
Hartgraves PM, Primoschi RE. An evaluation of oral and nasal midazolam for pediatric dental sedation. J Dent Child. 1994; 61:175-81.
Andrade ED. Terapêutica medicamentosa em odontologia: a importância da redução do estresse ao tratamento odontológico. São Paulo: Artes Médicas, 2002. p.39-64.
Hosey MT, Makin A, Jones RM, Gilchrist F, Carruthers M. Propofol intravenous conscious sedation for anxius children in a specialist pediatric dentistry unit. Int J Paediatr Dent. 2004; 14:2-8.
Cangiani LM, Porto AM. Anestesia ambulatorial. Rev Bras Anestesiol. 2000; 50:68-85.
Marshall W, Weaver BD, McCutcheon P. A study of the effectiveness of oral midazolam as a dental pre-operative sedation and hypnotic. Spec Care Dentist. 1999; 19:259-66.
Milnes AR, Paed D, Maupomé G, Cannon J. Intravenous sedation in pediatric dentistry using midazolan, nalbuphine and droperidol. Paediatr Dent. 2000; 22:113-24.
Miyake RS, Reis AG, Grisi S. Sedação e analgesia em crianças. Rev Assoc Méd Bras. 1998; 44:56- 64.
Hallonsten AL, Kock G, Schroder U. Nitrous oxide sedation in the dental care. Comm Dent Oral Epidemiol. 1983; 11:347-55.
Meyer ML, Mourino AP, Farrington FH. Comparison of triazolam to a chloral hydrate/ hydroxyzine combination in the sedation of pediatric dental patients. Pediatr Dent. 1990;
Wheler DS, Jensen RA, Poss WB. A randomized, blinded comparasion of cloral hydrate and midazolam sedation in children undergoing echocardiography. Clin Pediatr. 2001; 40:381-87.
Cravero JP, Blike GT. Review of pediatric sedation. Anesth Analg. 2004; 99:1355-64.
American Academy of Pediatric Dentistry. Guidelines for behavior management. Pediatr Dent. 1999; 21:42-6.
Mello HAS. Analgesia pelo óxido nitroso e oxigênio. Anais Acad Bras Odontol. 1975:168- 76.
Bailey P. Sedation and analgesia. Diagnostic for therapeutic procedures. Anesth Analg. 2003; 97:929-30.
Hulland SA, Freilich MM, Sàndor GKB. Nitrous oxide-oxygen or oral midazolam for pediatric outpatient sedation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002; 93:643-6.
Nizzia P, Pizzi S, Fazzi M. Sadation techniques in the dental treatment of with mental disabilities. Minerva Stomatol. 1998; 47:465-7.
Wilson KE, Welbury RR, Giedler NM. A randomized, controlled, crossover trial of oral midazolan and nitrous oxide for pediatric dental sedation. Anesthesia. 2002; 57:860-7.
Howard WR. Nitrous oxide in the dental environment: assessing the risk, reducing the exposure. J Am Dent Assoc. 1997; 12:47-54.
Iwasaki J, Vann Jr WF, Dilley, DCH, Anderson JA. An investigation of capnography and pulse oximetry as monitors of pediatric patients sedated for dental treatment. Pediatr Dent. 1989; 11:111- 7.
Ranalli J. Óxido Nitroso: por que usar? APCD Jornal. 2001; 5:529:32.
Weiner-Kronish JP, Gropper MA. Concious sedation. Eur J Anaesthesiol. 2002; 19:388.
Freeman R, Carson P. Relative analgesia and general dental practitioners: attitudes and intentions to provide conscious sedation for paediatric dental extractions. Int J Paediatr Dent. 2003;13:320-6.
Fukuta O, et al. The sedation effect of intranasal midazolam administration in the dental treatment of patients with mental disabilities. Part 1: the effect of a 0,2 mg/Kg dose. J Clin Pediatr Dent. 1993; 17:231-7.
Gallardo F, Cornejo G, Borie R. Oral midazolam as premedication for the apprehensive child before dental treatment. J Clin Pediatr Dent. 1994; 18:123-7.
Duque C, Abreu-e-Lima FCB. Midazolam: uma alternativa para sedação em odontopediatria. Rev Odonto Ciênc. 2005; 48:177-86.
Soberanis MAI, Rodrigues JIM. Sedación em odontopediatria: comparición del midazolam via intranasal, con el diazepan via oral. Rev ADM. 1995; 52:261-5.
Shapira J, et al. The effectiveness of midazolam and hydrozine as sedative agents for young pediatric dental patients. J Dent Child. 1996; 63:421-5.
Veerkamp JSJ, Gruythysen RJM, Van Amerongen WE. Anxiety reduction with nitrous oxide: a permanent solution? J Dent Child. 1995; 61:44-8.
Cravero JP, Blike GT. Review of pediatric sedation. Anesth Analg. 2004; 99:1355-64.
Nathan EJ. Managing behavior of precooperative children. Dent Clin North Am. 1995; 39:789-816. Recebido em 15/01/2010 - Aceito em 21/05/2010
