title: Conscious sedation of pediatric patients with combination oral benzodiazepines and inhaled nitrous oxide.
abstract: BACKGROUND
  Pediatric patients undergoing surgical procedures may experience considerable anxiety. Use of conscious sedation may be helpful in managing mild to moderate anxiety.
  
  
  OBJECTIVE
  To assess the effectiveness of combination oral benzodiazepines and inhaled nitrous oxide conscious sedation in pediatric surgical patients.
  
  
  METHODS
  Eleven episodes of conscious sedation in eight pediatric patients were prospectively monitored, with recording of indications, patient characteristics, clinical scenarios, surgical procedure, sedative regimen, quality of sedation, and complications. Extensive training in conscious sedation had been obtained, and emergency preparedness was at a high level.
  
  
  RESULTS
  Combination oral benzodiazepines and inhaled nitrous oxide produced good to excellent results in all patients but one. Complications were uncommon and mild. No emergency intervention was necessary.
  
  
  CONCLUSIONS
  Monitored use of a combination of oral benzodiazepine and low to moderate concentrations of inhaled nitrous oxide can provide safe and effective conscious sedation in pediatric patients. Training in conscious sedation and emergency preparedness are essential.
authors.affiliation: Department of Dermatology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
authors.forename: C C
authors.initials: CC
authors.lastname: Otley
authors.forename: T H
authors.initials: TH
authors.lastname: Nguyen
mesh_terms: D000280:Administration, Inhalation; D000284:Administration, Oral; D018685:Anesthetics, Inhalation / Q000008:administration & dosage* / Q000009:adverse effects; D014151:Anti-Anxiety Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001569:Benzodiazepines; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation / Q000009:adverse effects / Q000379:methods*; D062109:Dermatologic Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D009609:Nitrous Oxide / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies
chemical_list: D018685:Anesthetics, Inhalation; D014151:Anti-Anxiety Agents; D001569:Benzodiazepines; D009609:Nitrous Oxide