Inhaled sedation is a conscious form of sedation where the inhaled drug should:
- Suppress central nervous system (CNS) to a level that allows surgical treatment to be performed with minimal physiological and psychological stress
- Change the state of the patient's mind in such a way that communication is maintained and the patient can respond to verbal commands
- Bring a sufficiently wide security margin to create accidental loss of consciousness and loss of protective reflexes.
Video Inhalation sedation
Medical use
The following is the possibility of using conscious sedation "dental anxiety and phobia, the need for prolonged or traumatic dental procedures, potentially exacerbated medical conditions by stress (such as ischemic, hypertensive, asthma and epilepsy), medical or behavioral conditions affecting patients ability to work together, special care requirements ".
Maps Inhalation sedation
Side effects
Complications arising from inhaled sedation are rare and termed as requiring intervention to correct adverse physiological consequences that may inadvertently accompany sedation techniques. They include "over-sedation, respiratory depression/apnea, unconscious patients, airway obstruction, vomiting, idiosyncratic responses, delayed recovery and conscious sedation failure".
Some of the absolute contraindications that exist, however, "contraindications are relatively important and can only be considered after full assessment." They include:
- Medical conditions that would endanger inhalation of sedatives, such as runny nose, tonsillitis, severe COPD or nasal obstruction;
- Neuromuscular disease that affects the respiratory system, such as multiple sclerosis and myasthenia gravis;
- Women in the first trimester of pregnancy;
- Medical conditions or behavior that will limit the patient's ability to understand the procedure;
- Claustrophobia or "fear of masks".
Assessment and selection of patients
On a pre-treatment visit visit, a full assessment was conducted to summarize the most appropriate sedation and technique requirements for each patient. It consists of a detailed record of patient history and a thorough examination:
The medical, dental, and social history taken into account the patient's age, health condition, social circumstances, drug history and all special needs, to determine that the chosen conscious sedation technique is the most appropriate to enable successful treatment outcomes for each patient. individual.
Examination considers the patient's general appearance, skin color, pulse rate, blood pressure and respiratory rate.
It is recommended that "only patients in ASA classes I and II should normally be considered suitable for sedation in primary dental care settings" and that "patients in ASA class III or IV should be referred to appropriate secondary care (ie hospitals) that have care facilities critical. "
Tools & amp; security features
In the UK, machines used for the administration of inhalation sedation must follow the English Standards and be maintained in accordance with the manufacturer's guidelines.
Tools
The equipment used for inhalation sedation for dentistry includes:
- Gas cylinder
- Flowmeter
- The reservoir bag
- Conduction Tubing
- Respiratory aids (Nasal nose or facial mask)
Security features
The safe mechanism of oxygen is the most important safety feature of the equipment used in inhalation sedation. The nitrogen oxide stream is only allowed through the open valve when there is oxygen flow to the system. Under no circumstances when oxygen flow is less than 30%, nitrogen oxide stops flowing. This prevents the delivery of 100% nitric oxide and it becomes the standard on any sedation unit made today.
All nasal scarves must have the ability to scavenge - providing fresh gas for the patient through one or two hoses while the additional hose removes the gas exhaled by the patient through the vacuum system.
The pin index security system is installed to prevent incorrect installation of both cylinders in the wrong position. In addition, the cylinders are color-coded which further reduces the risk of incorrect cylinder placement.
The diameter index system is also applied to prevent errors connecting hoses and rods due to connection attachments as well as different diameter hoses and rods.
Pressure release devices that discharge cylinder contents into the atmosphere prevent cylinder explosions from overcharging. In an emergency, oxygen sprinklers or emergency oxygen systems pass through a high flow of high pressure oxygen directly from the source through the intermediate meter.
Some alarm systems are used to indicate a depleted supply of oxygen. Audible alarms are needed in Europe and are recommended in the United States.
History
Nitrous oxide was first discovered by Joseph Priestley in 1772. In 1795, Sir Humphrey Davy and surgeon J. B. Borlase experimented with nitrous oxide and inhalation effects. Davy then published a book in 1799 indicating the possible role of nitrous oxide in achieving mild anesthesia during surgical procedures. In 1824, Henry Hill Hickman used carbon dioxide to achieve "suspended animation" in animals; managed to reduce pain during the surgical procedure. In 1831, chloroform was invented by Justus von Liebig in Germany, Samuel Guthrie in New York and EugÃÆ'¨ne Soubeiran in France, all working independently. In 1842, a chemist in Rochester, William Edward Clarke gave Dr. Elijah Pope with his ether prior to his patient's tooth extraction. That same year, a doctor in Georgia, Dr. Crawford W. Long gave the ether to John Venable to release the neck tumor. In 1844, Dr. Horace Wells conducted an experiment on himself where he asked Professor Gardner Quincy Colton to give nitrous oxide to himself before the dental extraction of wisdom by Dr. John Riggs. Wells discovered that he did not know the procedure and did not feel pain during the procedure.
References
Source of the article : Wikipedia
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