Sedation in Pediatric Dental Procedures

Abstract

Demand of sedation in pediatric dental procedures is very important in which the dentist can handle with the children. There are many sedative drugs which used in sedation (their mode of action, properties and effects) as midazolam, ketamine, mepridine, … etc. Various modalities in pediatric dental sedation include conscious sedation and relative analgesia. In addition to sedation, role of general anaesthesia inpediatric dental procedures is present in some cases (indications). Methods of general anaesthesia are dental chair anaesthesia , day care anaesthesia and in patient anaesthesia. Post sedation events and outcomes associated with pediatric sedation occur in recovery or after discharge. The elimination half-life of sedatives often exceeds the duration of the dental appointment. There are potential side effects of the sedative drugs. Complications include airway obstruction,vomiting, respiratory obstruction, laryngospasm , laryngeal oedema , hypotension , and vasovagal syncope are the most observed post sedation events. The recent guidelines require anaesthiologists to record the depth of sedation for their patients during the sedation procedure via the bispectral index (BIS). BIS gathers processed EEG parameters to provide a numeric measure of the hypnotic effect of anesthetic or sedative drugs on brain activity. It is derived from the EEG by a computer algorithm that produces a single numeric value, scaled from 0 to 100.The goal of the BIS monitor is to provide an objective, quantitative measurement of the level of hypnosis. Recent studies have shown BIS scores to correlate with observational sedation scores during moderate and deep sedation in pediatric patients.