Reaction Times of Children Having Nitrous Oxide Inhalation Sedation for Dental Procedures

Overview

Journal Eur Arch Paediatr Dent

Publisher Springer

Specialties Dentistry
Pediatrics

Date 2019 Mar 18

PMID 30879260

Authors

A Lyne

J Johnson

D Baldwin

Affiliations

Soon will be listed here.

Abstract

Background: Inhalation sedation (IHS), using nitrous oxide and oxygen, is a commonly used form of pharmacological behaviour management in paediatric dentistry. Previous studies suggest that IHS causes a delay in reaction time, which recovers to baseline within 10 min.

Aim: To observe the reaction times (RT) of children before and after undergoing IHS for dental treatment.

Design: Sixty children from clinics at St Thomas' Hospital (London, UK) participated in this observational study. RT was measured using an eight-point choice reaction time system (MOART computer panel, Lafayette Instruments). RT was measured twice: before (prior to patient entering clinic for treatment) and after (immediately after discharge from the clinic). A paired-samples t test was used to analyse data.

Results: Fifty-two patients completed the study. There was a statistically significant delay in RT after treatment (p = 0.022). There was no significant correlation between RT and concentration of nitrous oxide, or length of the recovery period.

Conclusion: Children may have a small impairment in reaction times following recovery from IHS in the clinical setting, regardless of the strength of nitrous oxide given, or the length of the recovery period. The child's escort should be aware of the need to supervise the child following discharge.

References

Maylor E, Rabbitt P . Alcohol, reaction time and memory: a meta-analysis. Br J Psychol. 1993; 84 ( Pt 3):301-17. DOI: 10.1111/j.2044-8295.1993.tb02485.x. View

Millar K, Asbury A, Bowman A, Hosey M, Martin K, Musiello T . A randomised placebo-controlled trial of the effects of midazolam premedication on children's postoperative cognition. Anaesthesia. 2007; 62(9):923-30. DOI: 10.1111/j.1365-2044.2007.05148.x. View

Jakovljevic M, Vidmar G, Mekjavic I . Psychomotor function during mild narcosis induced by subanesthetic level of nitrous oxide: individual susceptibility beyond gender effect. Undersea Hyperb Med. 2013; 39(6):1067-74. View

Fagan D, Paul D, Tiplady B, Scott D . A dose-response study of the effects of inhaled nitrous oxide on psychological performance and mood. Psychopharmacology (Berl). 1994; 116(3):333-8. DOI: 10.1007/BF02245337. View

Norton J, Roth G, Matheny J, Falace D, OReilly J . The effect of nitrous oxide and age on psychological and psychomotor performance. Anesth Prog. 1984; 31(2):64-9. PMC: 2515534. View

Zacny J, Sparacino G, Hoffmann P, Martin R, Lichtor J . The subjective, behavioral and cognitive effects of subanesthetic concentrations of isoflurane and nitrous oxide in healthy volunteers. Psychopharmacology (Berl). 1994; 114(3):409-16. DOI: 10.1007/BF02249330. View

Millar K, Bowman A, Burns D, McLaughlin P, Moores T, Morton N . Children's cognitive recovery after day-case general anesthesia: a randomized trial of propofol or isoflurane for dental procedures. Paediatr Anaesth. 2013; 24(2):201-7. DOI: 10.1111/pan.12316. View

Armstrong P, Morton C, Sinclair W, Tiplady B . Effects of nitrous oxide on psychological performance. A dose-response study using inhalation of concentrations up to 15%. Psychopharmacology (Berl). 1995; 117(4):486-90. DOI: 10.1007/BF02246223. View

Gronbaek A, Svensson P, Vaeth M, Hansen I, Poulsen S . A placebo-controlled, double-blind, crossover trial on analgesic effect of nitrous oxide-oxygen inhalation. Int J Paediatr Dent. 2013; 24(1):69-75. DOI: 10.1111/ipd.12027. View

10.

Millar K, Asbury A, Bowman A, Hosey M, Musiello T, Welbury R . The effects of brief sevoflurane-nitrous oxide anaesthesia upon children's postoperative cognition and behaviour. Anaesthesia. 2006; 61(6):541-7. DOI: 10.1111/j.1365-2044.2006.04662.x. View

11.

Bryan R . The success of inhalation sedation for comprehensive dental care within the Community Dental Service. Int J Paediatr Dent. 2002; 12(6):410-4. DOI: 10.1046/j.1365-263x.2002.00400.x. View

12.

Thompson J, Neave N, Moss M, Scholey A, Wesnes K, Girdler N . Cognitive properties of sedation agents: comparison of the effects of nitrous oxide and midazolam on memory and mood. Br Dent J. 2000; 187(10):557-62. DOI: 10.1038/sj.bdj.4800330. View

13.

Pedersen R, Bayat A, Steen N, Jacobsson M . Nitrous oxide provides safe and effective analgesia for minor paediatric procedures--a systematic review. Dan Med J. 2013; 60(6):A4627. View

14.

Galinkin J, Janiszewski D, Young C, Klafta J, Klock P, Coalson D . Subjective, psychomotor, cognitive, and analgesic effects of subanesthetic concentrations of sevoflurane and nitrous oxide. Anesthesiology. 1997; 87(5):1082-8. DOI: 10.1097/00000542-199711000-00012. View