sedation: Dental treatment for people with challenging behaviour: general anaesthesia or sedation?
Article: Intravenous procedural sedation: An alternative in the treatment of patients with intellectual disability[show abstract] [hide abstract]
ABSTRACT: Conscious sedation has become established as an important alternative to general anesthesia (GA) in dental treatment of patients with intellectual disability (ID). Aim : to investigate dental patients undergoing sedation using a mean dose of 0.6 mg/kg intravenous midazolam and the adverse events of sedation in patients with ID. Methods: This study analyzed the records of 163 dental patients with ID aged between 2 and 76 years who had undergone conscious intravenous sedation (CIV) using a mean dose of 0.61 mg/kg of midazolam at Aragatuba Dental School, Sao Paulo State University, Brazil. The efficacy and complications induced by CIV were evaluated in each subject. Results: CIV was effective for dental treatment in 80% of the cases. A total of 626 dental procedures were performed. The mean treatment time was 33.9 minutes. There was statistically significant difference (p<0.05) between absence and presence of adverse reactions. Adverse reactions were observed in 21.47% of the cases. Conclusions : The results of this study showed that CIV is a useful method for dental treatment of patients with ID and these patients can need higher doses of sedative to reach an adequate level of sedation.Brazilian Journal of Oral Sciences (ISSN: 1677-3217) Vol 9 Num 1.
Article: Evaluating the population with intellectual disability unable to comply with routine dental treatment using the International Classification of Functioning, Disability and Health.[show abstract] [hide abstract]
ABSTRACT: The aim of this study was to investigate the use of general anaesthesia (GA) among patients with intellectual disability (ID) in relation to the International Classification of Functioning (ICF). Twenty-seven ICF codes related to the tolerance of the dental treatment were chosen. The sample consisted of 100 children with ID divided into two groups (50 patients in whom routine dental treatment had been accomplished and 50 patients who had been treated under GA). Differences between the groups were analysed using the chi-square test, bivariate correlation and multiple logistic regression analysis. The GA group showed higher levels with regard to the following codes: b117--intellectual function, b2801--pain in head and neck, d310--communication, d530--toileting, d540--dressing, e310--immediate family, e5400--transportation services and e5850--education and training services. The severity of ID significantly correlated with the 'Activities and Participation' codes. Three predictors of GA treatment were identified: 'Pain in head and neck' (p < 0.001), 'Transportation services, systems and policies' (p < 0.05) and 'Education and training services, systems and policies' (p < 0.05). The use of GA increases with the severity of ID. Acute and painful conditions result in more frequent use of GA. Unfavourable environmental factors present barrier to routine dental management.Disability and Rehabilitation 01/2011; 33(19-20):1746-54. · 1.50 Impact Factor
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