title: Sedation with 50% nitrous oxide/oxygen for outpatient dental treatment in individuals with intellectual disability.
abstract: Persons with intellectual disability have difficulty in cooperating with outpatient care, and many are referred for general anaesthesia. Intellectual disability has traditionally been a contraindication for conscious sedation. We evaluated the behavioural impact, effectiveness, and tolerance of sedation in this population using a fixed 50% nitrous oxide/oxygen mixture as a single agent. We used dental treatment as a model of outpatient care; 349 patients (192 males, 157 females; mean age 22y [SD 14]; range 3-81y) were recruited over a 12-month period at seven centres. Sedation was deemed successful if planned dental treatment was completed. Behaviour was scored with the modified Venham scale. Out of 605 sessions, 91.4% were successful. No serious adverse effects occurred. Minor adverse events (such as nausea) occurred in 10.1% of sessions. We conclude that the use of safe and effective conscious sedation may reduce the indications for general anaesthesia.
authors.affiliation: Service d'Odontologie, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France. denise.faulks@u-clermont1.fr
authors.forename: Denise
authors.initials: D
authors.lastname: Faulks
authors.forename: Martine
authors.initials: M
authors.lastname: Hennequin
authors.forename: Sylvie
authors.initials: S
authors.lastname: Albecker-Grappe
authors.forename: Marie-Cécile
authors.initials: MC
authors.lastname: Manière
authors.forename: Corinne
authors.initials: C
authors.lastname: Tardieu
authors.forename: Annie
authors.initials: A
authors.lastname: Berthet
authors.forename: Maryse
authors.initials: M
authors.lastname: Wolikow
authors.forename: Dominique
authors.initials: D
authors.lastname: Droz
authors.forename: Serge
authors.initials: S
authors.lastname: Koscielny
authors.forename: Peter
authors.initials: P
authors.lastname: Onody
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000766:Anesthesia, Dental; D002648:Child; D002675:Child, Preschool; D016854:Dental Anxiety / Q000517:prevention & control; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009609:Nitrous Oxide; D010045:Outpatients; D010100:Oxygen; D014076:Tooth Diseases / Q000523:psychology* / Q000628:therapy
chemical_list: D009609:Nitrous Oxide; D010100:Oxygen