Guelmann M, Brackett R, Beavers N, Primosch R E
Department of Pediatric Dentistry, University of Florida, USA.
J Clin Pediatr Dent. 2012 Fall;37(1):77-82. doi: 10.17796/jcpd.37.1.e2g45201l836689n.
The purpose of this study was to determine the effect of interrupted administration of nitrous oxide (N2O) inhalation, after obtaining profound local anesthesia, on the behavior of mild to moderately anxious pediatric patients during routine restorative dentistry.
Healthy children, 5 to 8 years old, requiring nitrous oxide/oxygen inhalation sedation and bilateral mandibular restorative treatment performed in two sequential appointments under local anesthesia were recruited for this study. After profoundness of the local anesthesia was confirmed, the subject was randomly assigned to either Protocol A (50% N2O/50% O2) or Protocol B (100% O2) and restorative dental care was completed. On the second appointment, the subject was assigned to the alternate protocol.
Hemoglobin oxygen saturation remained constant with no episodes of oxygen desaturation recorded. There were no statistically significant differences (P > .05) in pulse rate or behavior change noted between the two protocols.
The implication of this pilot study was significant in consideration of the desire to minimize chronic exposure to ambient nitrous oxide and its potential health hazards to the dental team. These findings challenge the traditional practice of N2O maintenance throughout the dental appointment.
本研究的目的是确定在获得深度局部麻醉后，间断给予笑气（N₂O）吸入对轻度至中度焦虑的儿科患者在常规修复牙科治疗期间行为的影响。
招募5至8岁、需要笑气/氧气吸入镇静并在局部麻醉下分两次连续进行双侧下颌修复治疗的健康儿童参与本研究。在确认局部麻醉达到深度后，将受试者随机分配至方案A（50% N₂O/50% O₂）或方案B（100% O₂），并完成修复牙科护理。在第二次就诊时，将受试者分配至另一种方案。
血红蛋白氧饱和度保持恒定，未记录到氧饱和度降低的情况。两种方案之间在脉搏率或行为变化方面未观察到统计学上的显著差异（P > 0.05）。
考虑到尽量减少牙科团队长期接触环境中笑气及其潜在健康危害的愿望，这项初步研究的意义重大。这些发现对在整个牙科就诊过程中持续使用笑气的传统做法提出了挑战。
