title: Oxygen saturation and diffusion hypoxia in children following nitrous oxide sedation.
abstract: Oxygen saturation of arterial blood (SaO2) was assessed in children after discontinuing N2O/O2 sedation for dental procedures. Two post-treatment methods were used: breathing 100% O2 for 5 min after the procedure, and breathing room air for 5 min. Participants were 24 healthy children ages 41 to 113 months. Each child was treated twice and a crossover design was used. The mean length of procedures that were followed by O2 was 28.8 (+/- 10.9 SD) min; for those followed by room air, 28.3 (+/- 12.4 SD) min. SaO2 was monitored continuously by pulse oximetry and recorded at predetermined intervals before, during, and after N2O/O2 administration. When participants received post-treatment O2, the mean SaO2 at 1 min after N2O cessation (99.91 +/- 0.63 SD) and 5 min after cessation (99.94 +/- 0.17 SD) was statistically significantly higher than the pretreatment value of 99.28 (+/- 0.63 SD). When participants received post-treatment room air, the mean SaO2 1 min after N2O cessation (99.44 +/- 0.8) was also statistically significantly higher than the pretreatment mean (99.08 +/- 0.96). After 2 min, however, the mean SaO2 decreased and was statistically indistinguishable from the pretreatment level after 5 min (99.13 +/- 0.9 SD). Fluctuations in SaO2, though statistically significant, were less than 1%. Allowing children to breathe room air immediately after cessation of N2O/O2 inhalation did not reduce SaO2 below clinically acceptable levels. This study further documents the safety of N2O/O2 sedation, and gives the clinician additional information concerning the safe and effective administration of inhalation sedation. (Pediatr Dent 15:88-92, 1993).
authors.affiliation: Department of Pediatric Dentistry, Medical College of Georgia, Augusta, Ga.
authors.forename: T
authors.initials: T
authors.lastname: Dunn-Russell
authors.forename: S M
authors.initials: SM
authors.lastname: Adair
authors.forename: D R
authors.initials: DR
authors.lastname: Sams
authors.forename: C M
authors.initials: CM
authors.lastname: Russell
authors.forename: J T
authors.initials: JT
authors.lastname: Barenie
mesh_terms: D000704:Analysis of Variance; D000766:Anesthesia, Dental / Q000009:adverse effects* / Q000379:methods; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation / Q000009:adverse effects* / Q000379:methods; D004058:Diffusion; D006801:Humans; D000860:Hypoxia / Q000209:etiology*; D009609:Nitrous Oxide / Q000009:adverse effects*; D010100:Oxygen / Q000097:blood*
chemical_list: D009609:Nitrous Oxide; D010100:Oxygen