An equivalence study comparing nitrous oxide and oxygen with low-dose sevoflurane and oxygen as inhalation sedation agents in dentistry for adults.
OBJECTIVE
The aim of this study was to examine whether sevoflurane in oxygen was equivalent to near equipotent concentrations of nitrous oxide in oxygen when used as an inhalation sedation agent in terms of patient and user acceptability.


METHODS
Forty anxious dental patients referred to the sedation suite at Cardiff University School of Dentistry received either nitrous oxide to a maximum concentration of 40% or sevoflurane to a maximum concentration of 0.3% for a routine maxillary plastic restoration with articaine infiltration local analgesia. The inhalation sedation agent to be administered was chosen by a random number allocator. Measurements of blood pressure, oxygen saturation, heart rate, respiratory rate and bispectral index were recorded every 5 minutes. At the end of the treatment episode the patient, the operator and an observer who was unaware of the agent used, recorded their impressions about the episode by completing questionnaires.


RESULTS
In the doses used in this study, sevoflurane was found to be as effective as an inhalation sedation agent as the standard dose of nitrous oxide used in normal inhalation sedation in the treatment of adult anxious dental patients.


CONCLUSIONS
Sevoflurane in low concentrations is equivalent in effect to near equipotent concentrations of nitrous oxide. This would suggest that further research, perhaps with slightly higher concentrations of sevoflurane, is needed. If sevoflurane was shown to be acceptable at slightly higher concentrations, there is scope to explore the development of equipment specifically designed to deliver sevoflurane as an inhalation sedation agent in future.
Sedation and Special Care Dentistry.
M
M
Allen
Sedation and Special Care Dentistry, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Heath Park, Cardiff, CF14 4XY.
S
S
Thompson
D000293:Adolescent; D000328:Adult; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D003752:Dental Health Services; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage*; D008875:Middle Aged; D009609:Nitrous Oxide / Q000008:administration & dosage*; D010100:Oxygen / Q000008:administration & dosage*; D000077149:Sevoflurane; D055815:Young Adult
D018685:Anesthetics, Inhalation; D006993:Hypnotics and Sedatives; D008738:Methyl Ethers; D000077149:Sevoflurane; D009609:Nitrous Oxide; D010100:Oxygen