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Introdução: O manejo no atendimento odontológico infantil torna-se fatigante quando não há cooperação por parte da criança e/ou dos responsáveis. A fim de minimizar esses quadros, quando não existe sucesso das técnicas de abordagem comportamental tradicionais, métodos terapêuticos alternativos têm sido amplamente estudados, em especial a sedação consciente com óxido nitroso associada ou não a fármacos sedativos. Objetivo: Dessa forma, objetivou-se realizar uma revisão crítica da literatura norteando o cirurgião-dentista sobre o uso do óxido nitroso e sua associação a fármacos, esclarecendo suas indicações, vantagens e desvantagens. Métodos: Foi realizada uma busca integrativa da literatura nacional e internacional, entre 2004 a 2019, nas bases Bireme e PubMed, utilizando os descritores: sedação consciente, ansiedade no tratamento odontológico e óxido nitroso. Resultados: No total, 43 artigos foram incluídos nesse estudo. O óxido nitroso tem sido bastante utilizado na odontologia, especialmente na odontopediatria. Este atua no sistema nervoso, promovendo uma leve depressão do córtex cerebral e não deprime o centro respiratório, sendo considerado seguro. A técnica pode ser combinada a outros fármacos, como Midazolam e Prometazina, sendo que cada abordagem medicamentosa apresenta suas indicações e vantagens específicas. Conclusão: A sedação consciente mostra-se como um método viável, e quando bem indicada é considerada segura. Seu papel na Odontologia vem sendo consolidado com o tempo, em decorrência dos inúmeros benefícios encontrados. No entanto, ainda existe certa resistência na utilização da mesma, tanto por parte dos responsáveis como também de alguns profissionais. Descritores: Sedação Consciente; Ansiedade ao Tratamento Odontológico; Óxido Nitroso. Referências Jain S. Sedation: A Primerfor Pediatricians. Pediatr Ann. 2018;47(6):254-58. Ashley PF, Chaudhary M, Lourenço-Matharu L. Sedation of children undergoing dental treatment. Cochrane Database Syst Rev.2018;12:1-152 Mozafar S, Bargrizan M, Golpayegani MV, Shayeghi S, Ahmadi R . Comparison of nitrous oxide/midazolam and nitrous oxide/promethazine for pediatric dental sedation: A randomized, cross-over, clinical trial. Use of nitrous oxide for pediatric patients. Dent Res J (Isfahan). 2018;15(6):411-19. Johnson C, Weber-Gasparoni K, Slayton RL, Qian F. Conscious sedation attitudes and perceptions: a survey of american academy of pediatric dentistry members. Pediatr Dent. 2012;34(2):132-37. Hand D, Averley P, Lyne J, Girdler N. Advanced paediatric conscious sedation: an alternative to dental general anaesthetic in the U.K. SAAD Dig. 201;27:24-9. Holroyd I. Conscious sedation in pediatric dentistry. A short review of the current UK guidelines and the technique of inhalational sedation with nitrous oxide. Paediatr Anaesth. 2008;18(1):13-7. Naudi AB, Campbell C, Holt J, Hosey MT. An inhalation sedation patient profile at a specialist paediatric dentistry unit: a retrospective survey. Eur Arch Paediatr Dent. 2006;7(2):106-9, Blumer S, Iraqui R, Bercovich R, Peretz B. Oxygen saturation and pulserate change in children during sedation with oral midazolam and nitrous oxide. J Clin Pediatr Dent. 2018;42(6):461-64. Choi SC, Yang Y, Yoo S, Kim J, Jeong T, Shin TJ. Decelopment of a web-based nationwide Korean pediatric dental sedation registry. J Clin Pediatr Dent. 2017;41(6):478-81. Wilson S, Houpt M . Project USAP 2010: use of sedative agents in pediatric dentistry- a 25- yar follow up survey. J Pediatr Dent.2016;38(2):127-33. Wilson S, Gosnell ES. Survey of American academy of pediatric dentistry on nitrous oxide and sedation: 20 years later. J Pediatr Dent. 2016;38(5):385-92. White J, Wells M, Arheart KL, Donaldson M, Woods MA. A questionnaire of parental perceptions of conscious sedation in pediatric dentistry. J Pediatr. Dent. 2016;38(2):116-21. Nelson TM, Xu Z. Pediatric dental sedation: challenges and opportunities. Clin Cosmet Investig Dent. 2015;7:97-106. Czlusniak GD, Rehbein M, Regattieri LR. Sedação consciente com oxido nitroso e oxigênio (NO2/O2): avaliação clínica pela oxime Publ. UEPG Ci Biol Saúde. 2007;13(4):23-8. Bham F, Perrie H, Scribante J, Lee CA. Paediatric dental chair sedation: An audit of current practice in Gauteng, South Africa. S Afr Med J. 2015;105(6):461-64. Diedericks BJ. Paediatric dental sedation: Will your child return home unharmed? S Afr Med J. 2015;105(6):453. Wilson S, Gosnell ES. Survey of American Academy of Pediatric Dentistry on Nitrous Oxide and Sedation: 20 Years Later. J Pediatr Dent. 2016;38(5):385-92. Levering NJ, Welie JVM. Current status of nitrous oxide as a behavior management practice routine in pediatric dentistry. J Dent Child (Chic). 2011;78(1):24-30. Ashley PF, Chaudhary M, Lourenço-Matharu L. Sedation of children undergoing dental treatment. Cochrane Database Syst Rev. 2018;12:3877. Hariharan S, Hosey MT, Bernabe E . Comparing the profile of child patients attending dental general anaesthesia and conscioussedation services. Br Dent J. 2017;222(9):683-87. Miranda-Remijo D, Orsini MR, Corrêa-Faria P, Costa LR. Mother-child interactions and young child behavior during procedural conscious sedation. BMC Pediatr. 2016;16(1):201. Morin A, Ocanto R, Drukteinis L, Hardigan PC . Survey of Current Clinical and Curriculum Practices of Postgraduate Pediatric Dentistry Programs in Nonintravenous Conscious Sedation in the United States. J Pediatr Dent. 2016;38(5):398-405. Woolley SM, Hingston EJ, Shah J, Chadwick BL. Paediatric conscious sedation: views and experience of specialists in paediatric dentistry. Br Dent J. 2009;207(6):280-81. 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 Pediatr Dent. 2004;14:2-8 Nathan JE .Effective and safe pediatric oral conscious sedation: philosophy and practical considerations. Alpha Omegan. 2006;99(2):78-82. Wilson S, Houpt M. Project USAP 2010: Use of Sedative Agents in Pediatric Dentistry-a 25-year Follow-up Survey. Amer Acad of Ped Dent. 2016;38(2):127-33. Paterson SA, Tahmassebi JF. Paediatric dentistry in the new millennium: 3. Use of inhalation sedation in paediatric dentistry. Dent Update. 2003;30(7):350-58. Wilson S. A survey of the American Academy of Pediatric Dentistry membership: nitrous oxide and sedation. Pediatr Dent. 1996;18(4):287-93. Zhong T, Hu D. Technology of nitrous oxide/oxygen inhalation sedation and its clinical application in pediatric dentistry. Hua Xi Kou Qiang Yi Xue Za Zhi. 2014;32(1):101-4. Levering NJ, Welie JVM. Ethical considerations in the use of nitrous oxide in pediatric dentistry. J Am Coll Dent;77(2):40-7 American academy of pediatric dentistry: recommendations- best practices. Reference manual. 2018;40(6):281-86. American academy of pediatric dentistry. Guideline on use of nitrous oxide for pediatric dental patients. 2011;33(6):181-84. Wilson KE. Overview of paediatric dental sedation: 2. Nitrous oxide/oxygen inhalation sedation. Dent Update. 2013;40(10):822-29. Foley J. A prospective study of the use of nitrous oxide inhalation sedation for dental treatment in anxious children. Eur J Paediatr Dent. 2005;6(3):121-28. Paterson SA, Tahmassebi JF. Paediatric dentistry in the new millennium: 3. Use of inhalation sedation in paediatric dentistry.Dent Update. 2003;30(7):350- Veerkamp JS, Gruythuysen RJ, Van Amerongen WE, Hoogstraten J. Dental treatment of fearful children using nitrous oxide. Part 2: The parent's point of view. ASDC J Dent Child.1992;59(2):115-19. Veerkamp JS, Van Amerongen WE, Hoogstraten J, Groen HJ. Dental treatment of fearful children, using nitrous oxide. Part I: Treatment times. ASDC J Dent Child.1991;58(6): 453-457. Muller TM, Alessandretti R, Bacchi A, Tretto PHW. Eficácia e segurança da sedação consciente com óxido nitroso no tratamento pediátrico odontológico: uma revisão de estudos clínicos. J Oral Invest. 2018;7(1):88-111. Woolley SM, Hingston EJ, Shah J, Chadwick BL. Paediatric conscious sedation: views and experience of specialists in paediatric dentistry. Br Dent J. 2009;207(6):280-81. Kotz S. Withdrawal symptoms in long-term conscious sedation exposure of pediatric intensive care patients. Kinderkrankenschwester. 2012;31(8):330-32. Fuhrer CT 3rd, Weddell JA, Sanders BJ, Jones JE, Dean JA, Tomlin A.Effect on behavior of dental treatment rendered under conscious sedation and general anesthesia in pediatric patients. J Pediatr Dent. 2009;31(7):492-97. Holroyd I. Conscious sedation in pediatric dentistry. A short review of the current UK guidelines and the technique of inhalational sedation with nitrous oxide. Paediatr Anaesth. 2008;18(1):13-7. Alexopoulos E, Hope A, Clark SL, McHugh S, Hosey MT.A report on dental anxiety levels in children undergoing nitrous oxide inhalation sedation and propofol target controlled infusion intravenous sedation. Eur Arch Paediatr Dent. 2007;8(2):82-6. |
