Clinical Significance
N2O/O2 inhalation is successfully used to perform restorative treatments in children and adolescents. However, this study indicates that this method has no analgesic effect on
InquiryNitrous oxide−oxygen sedation
Section snippets
Background
Dental treatment of children often involves the use of nitrous oxide−oxygen (N2O/O2) inhalation as a sedative technique. An analgesic effect is often expected for N2O/O2 but the evidence supporting this is lacking. For children it is important to obtain pain control to reduce dental anxiety and behavior management problems and avoid causing long-term avoidance of dental care. The analgesic effect of N2O/O2 inhalation in children was investigated.
Methods
Fifty-six subjects age 12 to 15 years participated in this placebo-controlled, double-blind, crossover trial. They were randomly assigned to receive by mask atmospheric air at the first session, then N2O/O2 at the second, or N2O/O2 at the first session and atmospheric air at the second. Among the variables noted were reaction time, pulp pain sensitivity, jaw muscle pressure pain thresholds, and overall discomfort as measured on a visual analog scale (VAS) through pain testing.
Results
The use of N2O/O2 inhalation increased reaction time significantly, but no effect remained 10 and 30 minutes after the mask was removed. Fifteen minutes after the mask was placed and inhalation was begun, the tooth-pulp pain sensitivity was highly significantly reduced in those receiving N2O/O2 compared to those receiving air, although the effect was absent when adjustment was made for increased reaction time. Ten and 30 minutes after the mask was removed, no effect remained. Fifteen minutes
Discussion
No analgesic effect was noted on tooth-pulp sensitivity with the use of N2O/O2 inhalation after the increase in reaction time was considered. However, an analgesic effect on pressure-induced muscle pain was identified that remained significant after reaction time increase was taken into account.
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Grøbæk AB, Svensson P, Væth M, et al: A placebo-controlled, double-blind, crossover trial on analgesic effect of nitrous oxide−oxygen inhalation. Int J Paediatr Dent 24:69-75, 2014
Reprints available from S Poulsen, Dept of Dentistry, Pediatric Dentistry, Health, Aarhus Univ, Vennelyst Blvd 9, DK-8000 Aarhus C, Denmark; e-mail: [email protected]
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