Inhalation sedation with sevoflurane: a comparative study with nitrous oxide.

1st Department of Oral and Maxillofacial Surgery, Nagasaki University School of Dentistry, Japan.
Journal of Oral and Maxillofacial Surgery (Impact Factor: 1.28). 02/1995; 53(1):24-6; discussion 26-7.
Source: PubMed

ABSTRACT To evaluate the possibility of using sevoflurane for inhalation sedation.
Thirty-five volunteers were divided randomly into two groups: sevoflurane group (n = 20) and nitrous oxide (N2O) group (n = 15). At the beginning of the sedation they all inhaled 100% O2, then a 0.1 minimum alveolar concentration (MAC) of sevoflurane or 10% N2O with oxygen, a 0.2 MAC of sevoflurane or 20% N2O with oxygen, and 0.3 MAC of sevoflurane or 30% N2O with oxygen for 10 minutes each.
The respiratory and cardiovascular functions were stable during inhalation of the gas mixtures. There were five negative comments about breathing N2O, but none about breathing sevoflurane.
All subjects in the sevoflurane group stated they would be willing to submit to the same inhalation procedure again.

  • [Show abstract] [Hide abstract]
    ABSTRACT: The objective of this prospective descriptive study was to report our experience with an alternative general anesthetic technique, using sevoflurane for the pediatric patient, in an ambulatory setting. Twenty consecutive pediatric patients participated over a 4-month period. A general anesthetic technique, using mask induction with sevoflurane and maintenance with a nasal trumpet as airway, was used throughout the surgical procedure. A standard anesthesia and recovery record was made for each patient; this included observations for untoward effects and complications. The average time for induction of anesthesia was 95 seconds, time from termination of sevoflurane to eye opening was 8 minutes, and duration of recovery was 30 minutes. Procedure time for each case did not exceed 10 minutes. Two patients had transient tachycardia. The results of this prospective descriptive study indicate that this technique is an effective and acceptable alternative to other modalities for the control of apprehension and fear in the pediatric patient in an ambulatory oral and maxillofacial facility.
    Journal of Oral and Maxillofacial Surgery 12/2003; 61(11):1249-52. DOI:10.1016/S0278-2391(03)00723-7 · 1.28 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Throughout the world there is considerable variation in the techniques used to manage anxious dental patients requiring treatment. Traditionally anxious or phobic dental patients may have been sent for general anaesthesia to allow dental treatment be undertaken. While this is still the case for the more invasive oral surgical procedures, such as wisdom teeth extraction, sedation in general dentistry is becoming more popular. Various sedation techniques using many different anaesthetic agents have gained considerable popularity over the past 30 years. While the practice of sedating patients for dental procedures is invaluable in the management of suitably assessed patients, patient safety must always be the primary concern. Medical, dental and psychosocial considerations must be taken into account when evaluating the patient need and the patient suitability for sedation or general anaesthesia. The regulations that govern the practice of dental sedation vary throughout the world, in particular regarding the techniques used and the training necessary for dental practitioners to sedate patients. It is necessary for medical and dental practitioners to be up to date on current practice to ensure standards of practice, competence and safety throughout our profession. This article, the first in a two-part series, will provide information to practitioners on the practice of sedation in dentistry, the circumstances where it may be appropriate instead of general anaesthesia and the risks involved with sedation. It will also discuss the specific training and qualifications required for dental practitioners to provide sedation. The second article in this series will outline the different techniques used to administer inhalation, oral and intravenous sedation in dentistry and will focus on specific methods that are practiced.
    Australasian Medical Journal 12/2013; 6(12):713-718. DOI:10.4066/AMJ.2013.1836
  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this case series study was to evaluate the advantages and disadvantages of using local anesthesia and conscious sedation (CS) rather than general anesthesia (GA) for performing functional surgery on patients suffering from temporomandibular joint (TMJ) closed lock, using the eminectomy procedure. Performing this procedure using CS allows functional assessment of the TMJ meniscus at the time of surgery. The objectives of this study were to determine if this surgery is possible under CS, to determine the benefits of being able to see the meniscus in action, and to investigate the patients' acceptability for this form of anesthesia. Twenty-two patients who underwent this eminectomy procedure under either CS or GA on a day-case basis participated in this retrospective case series study. All the recruited patients had this procedure carried out after a course of nonsurgical conservative treatment that had failed to relieve the symptoms associated with their TMJ disorder--"closed lock." Objective results obtained were as follows: preoperative and postoperative mouth opening; preoperative investigations; preoperative treatments. Subjective results obtained were as follows: preoperative and postoperative pain; noises; clicks; hearing and deviation on opening; patient rating of operation success. Paired t testing showed a significant change in mouth opening for both groups. The mean mouth opening change in the CS group (n = 9) was 10.6 mm (P = .014) and in the GA group (n = 13) was 13.7 mm (P < .001). An unpaired t test showed there is no statistical difference between these groups (P = .467). The subjective data recorded showed comparable outcomes and acceptance for the 2 techniques in terms of pain and operation success. The use of local anesthesia and CS is an alternative to GA for performing TMJ procedures in appropriately selected patients. The advantage of direct visualization of the meniscus and its movements in the nonasleep patient requires further evaluation.
    Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 03/2011; 69(6):e42-9. DOI:10.1016/j.joms.2010.11.034 · 1.28 Impact Factor