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This study was designed to evaluate the efficacy and safety of intranasal sufentanil/midazolam [S/M] and ketamine/madazolam [K/M] for sedation and analgesia in preschool children that require dental surgery [extractions].<br /> <br /> Fifty children [ASA 1] aged 5 &ndash / 7 years, requiring six or more dental extractions under general anaesthesia, were allocated to two groups of 25 children to receive either ketamine 5 mg/kg or sufentanil 20&mu / g intranasally, 20 minutes before induction of surgery in this randomised double-blind study. All the children in both groups in addition concurrently received nasal midazolam 0,3 mg/kg. For induction of anaesthesia, sevoflurane in nitrous oxide and oxygen, was used.<br /> <br /> S/M was accepted significantly better as a nasal pre-medication [p&lt / 0.05]. Both groups were equally sedated and a smooth mask induction of anaesthesia was experienced in the majority of children. Recovery of children in both groups were similar / 82% of the S/M group were fully recovered 120 minutes post-operatively versus 80% in the K/M group [p&gt / 0,05]. Effective postoperative analgesia for multiple extractions was provided. For pain evaluation, children were divided into two groups, a non-responder group where all pain values over time were more than 40 and a responder group where pain values were equal to, or less than 40. Seventy two percent of children in the S/M group were responders as to fifty two percent in the K/M group [p&gt / 0,05]. No adverse respiratory, cardiovascular or other effects were recorded. This study showed that intranasal administration of sufentanil /midazolam or ketamine/midazolam, provides safe and effective sedation and analgesia in children aged 5&ndash / 7 years undergoing multiple dental extractions.

<p>This thesis covered the fast track assessment of the referred dental patient for conscious sedation in a day clinic. The assessment took in consideration patient information, medical history, anatomical observations, treatment required, phobic aspects and patient expectations.</p>

Intravenous administration of benzodiazepines can be used for anxiety management in dentistry. The recent approval of Dexmedetomidine in Canada provides an alternative to benzodiazepines for moderate sedation. There is no review comparing Dexmedetomidine and Midazolam as a sole agent for intravenous moderate sedation. This paper determines to fill the void of knowledge. A total of 6 articles out of 117 were identified in Pubmed and Ovid Medline using the key terms “Dexmedetomidine” and “sedation”. The parameters that were evaluated were the need for rescue, patient and surgeon satisfaction, and adverse outcomes. Dexmedetomidine was found to be equal or better than Midazolam in the first three parameters. Hypotension and bradycardia were evident in moderate to high doses, but none needing intervention. Other side effects include headache and dry mouth. Dexmedetomidine is a reasonable and safe alternative to Midazolam, but more research is needed to evaluate Dexmedetomidine for general dentistry.

This study investigated Ontario dentists' views and use of sedation and general anaesthesia (GA) (n=1076; 37.9% response rate). A mixed mode format offered mailed and web survey options. Study participants were 69.7% male, 83.0% general practitioners, practicing 0.5-42 years (mean 20.6 years), with 40.6% from cities &gt;500,000. 60.2% of respondents provided sedation. Dentists' underestimated patient interest in sedation/GA (66.8% vs. 43.9% not interested; 19.8% vs. 42.8% possibly interested; 13.4% vs. 12.4% definitely interested). Patients' preference for sedation/GA by service was also underestimated (p&lt;0.001) except for extractions. Barriers to care were cost (72.2%) for providers; lack of training (38.2%) and patient demand (25.3%) for non-providers. Dentists reported use of sedation highest for extractions (1.5% deep sedation/GA-5.7% nitrous). Dentists' also overestimated patients' level of fear (somewhat afraid 19.95 vs. 9.8%; very afraid 10.6% vs. 2.0%; terrified 6.0% vs. 3.5%). This study confirms differences between dentists' use and estimation of patient demand for sedation/GA.

<p>The purpose of this research project was to assess the safety and efficacy of a combination of drugs for conscious sedation in patients undergoing office-based plastic and reconstructive surgery. A pilot study was done to determine the safety of the co-administration of the drugs used in the sedation technique.</p>

Intravenous administration of benzodiazepines can be used for anxiety management in dentistry. The recent approval of Dexmedetomidine in Canada provides an alternative to benzodiazepines for moderate sedation. There is no review comparing Dexmedetomidine and Midazolam as a sole agent for intravenous moderate sedation. This paper determines to fill the void of knowledge. A total of 6 articles out of 117 were identified in Pubmed and Ovid Medline using the key terms “Dexmedetomidine” and “sedation”. The parameters that were evaluated were the need for rescue, patient and surgeon satisfaction, and adverse outcomes. Dexmedetomidine was found to be equal or better than Midazolam in the first three parameters. Hypotension and bradycardia were evident in moderate to high doses, but none needing intervention. Other side effects include headache and dry mouth. Dexmedetomidine is a reasonable and safe alternative to Midazolam, but more research is needed to evaluate Dexmedetomidine for general dentistry.

This study investigated Ontario dentists' views and use of sedation and general anaesthesia (GA) (n=1076; 37.9% response rate). A mixed mode format offered mailed and web survey options. Study participants were 69.7% male, 83.0% general practitioners, practicing 0.5-42 years (mean 20.6 years), with 40.6% from cities &gt;500,000. 60.2% of respondents provided sedation. Dentists' underestimated patient interest in sedation/GA (66.8% vs. 43.9% not interested; 19.8% vs. 42.8% possibly interested; 13.4% vs. 12.4% definitely interested). Patients' preference for sedation/GA by service was also underestimated (p&lt;0.001) except for extractions. Barriers to care were cost (72.2%) for providers; lack of training (38.2%) and patient demand (25.3%) for non-providers. Dentists reported use of sedation highest for extractions (1.5% deep sedation/GA-5.7% nitrous). Dentists' also overestimated patients' level of fear (somewhat afraid 19.95 vs. 9.8%; very afraid 10.6% vs. 2.0%; terrified 6.0% vs. 3.5%). This study confirms differences between dentists' use and estimation of patient demand for sedation/GA.

This study was designed to evaluate the efficacy and safety of intranasal sufentanil/midazolam [S/M] and ketamine/madazolam [K/M] for sedation and analgesia in preschool children that require dental surgery [extractions].<br /> <br /> Fifty children [ASA 1] aged 5 &ndash / 7 years, requiring six or more dental extractions under general anaesthesia, were allocated to two groups of 25 children to receive either ketamine 5 mg/kg or sufentanil 20&mu / g intranasally, 20 minutes before induction of surgery in this randomised double-blind study. All the children in both groups in addition concurrently received nasal midazolam 0,3 mg/kg. For induction of anaesthesia, sevoflurane in nitrous oxide and oxygen, was used.<br /> <br /> S/M was accepted significantly better as a nasal pre-medication [p&lt / 0.05]. Both groups were equally sedated and a smooth mask induction of anaesthesia was experienced in the majority of children. Recovery of children in both groups were similar / 82% of the S/M group were fully recovered 120 minutes post-operatively versus 80% in the K/M group [p&gt / 0,05]. Effective postoperative analgesia for multiple extractions was provided. For pain evaluation, children were divided into two groups, a non-responder group where all pain values over time were more than 40 and a responder group where pain values were equal to, or less than 40. Seventy two percent of children in the S/M group were responders as to fifty two percent in the K/M group [p&gt / 0,05]. No adverse respiratory, cardiovascular or other effects were recorded. This study showed that intranasal administration of sufentanil /midazolam or ketamine/midazolam, provides safe and effective sedation and analgesia in children aged 5&ndash / 7 years undergoing multiple dental extractions.