Journal of the korean academy of Pediatric Dentistry (대한소아치과학회지)

Korean Academy of Pediatric Dentistry (대한소아치과학회)
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Determination of Physiological Changes according to Nitrous Concentration and Application Method

아산화질소 농도 및 적용방법에 따른 생리학적 변화

  • Lee, Daewoo (Department of Pediatric Dentistry and Institute of Oral Bioscience, School of Dentistry, Chonbuk National University) ;
  • Han, Jihoon (Department of Pediatric Dentistry and Institute of Oral Bioscience, School of Dentistry, Chonbuk National University) ;
  • Yang, Yeonmi (Department of Pediatric Dentistry and Institute of Oral Bioscience, School of Dentistry, Chonbuk National University)
  • 이대우 (전북대학교 치의학전문대학원 소아치과학교실 및 구강생체과학연구소) ;
  • 한지훈 (전북대학교 치의학전문대학원 소아치과학교실 및 구강생체과학연구소) ;
  • 양연미 (전북대학교 치의학전문대학원 소아치과학교실 및 구강생체과학연구소)
  • Received : 2016.10.20
  • Accepted : 2016.10.27
  • Published : 2016.11.30
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Abstract

The aim of this study was to analyze physiological changes, clinical and subjective symptoms by different $N_2O$ concentrations and administration method. This study surveyed 65 men and women ages 19 to 35 and all subjects were healthy volunteers, with no contraindication for use of $N_2O$ sedation. The $N_2O$ sedation was carried out in a way that increases by 10 percent to one-minute interval or increases at once the desired level. Each method was required to reach 30 or 50 percent $N_2O$ concentration. The way to gradually raise the $N_2O$ concentration can reduce the risk by decreasing the pulse reduction rate at the same $N_2O$ concentration. $SpO_2$ has no statistical significance according to $N_2O$ concentration and method of administration. Pulse rate reduced significantly when 50% $N_2O$ increase at once during sedation and 100% $O_2$ after 5 minutes. The way to gradually raise the $N_2O$ concentration is safe for reducing pulse rate.

본 연구는 $N_2O/O_2$ 흡입진정을 시행하였을 때, 농도 및 투여방법에 따른 환자의 생징후 변화, 주관적인 증상 및 부작용에 대해 알아보고자 하였다. 본 연구는 흡입진정법에 대한 금기증이 없는 19 - 35세 성인 남녀 65명을 대상으로 실험조사를 진행하였다. 흡입진정법은 $N_2O$의 농도를 약 1분 간격으로 10%씩 높여주는 방법으로 적정하거나, 한 번에 $N_2O$의 농도를 원하는 수준으로 올려주는 방법을 시행하였다. 각각의 방법으로 30% 또는 50% $N_2O$ 농도에 도달되도록 하였다. 산소포화도는 $N_2O$ 농도와 투여방법에 따라서 유의성 있는 결과를 보이지 않았다. 맥박수는 한 번에 $N_2O$를 고농도로 투여하는 경우 진정법 중과 100% $O_2$ 5분 투여 후 유의성 있는 감소를 보였다. 따라서 $N_2O$ 농도는 서서히 올려주는 것이 환자 맥박수의 감소량을 줄이는 것이 안전하다.

Keywords

References

  1. Houpt MI, Limb R, Livingston RL : Clinical effects of nitrous oxide conscious sedation in children. Pediatr Dent, 26:29-36, 2004.
  2. Malamed SF : Sedation : A Guide to Patient Management, 5th ed. Mosby, 13-15, 2010.
  3. Kim JY, Jeong TS, Shin TJ, et al. : Agents used for pediatric dental sedation. J Korean Acad Pediatr Dent, 43:109-116, 2016. https://doi.org/10.5933/JKAPD.2016.43.1.109
  4. American Dental Association Guidelines for the use of sedation and general anesthesia by dentists. Assessment service. Available from URL: http://www.ada.org/-/media/ADA/About%20the%20ADA/Files/anesthesia_use_guidelines.ashx (Accessed on October 26, 2016).
  5. Hosey MT : Managing anxious children : the use of conscious sedation in paediatric dentistry. Int J Paediatr Dent, 12:359-372, 2002.
  6. Choi YS, Shim YS : Sedation practices in dental office : A survey of members of the korean academy of pediatric dentistry. J Korean Acad Pediatr Dent, 26:579-587, 1999.
  7. Yang YM, Shin TJ, Jeong TS, et al. : Survey of sedation practices by pediatric dentists. J Korean Acad Pediatr Dent, 41:257-265, 2014. https://doi.org/10.5933/JKAPD.2014.41.3.257
  8. American Academy of Pediatric Dentistry : Guideline on use of nitrous oxide for pediatric dental patients. Pediatr Dent, 35:174-178, 2013.
  9. Paterson SA, Tahmassebi JF : Pediatric dentistry in the new millennium: Use of inhalation sedation in pediatric dentistry. Dent Update, 30:350-358, 2003. https://doi.org/10.12968/denu.2003.30.7.350
  10. McDonald RE, Avery DR, Dean J : McDonald and Avery's Dentistry for the child and adolescent, 8th ed. Mosby, 294-301, 2004.
  11. Korean Academy of Pediatric Dentistry : Pediatric, adolescent dentistry, 5th ed. Yenang INC., 239-248, 2014.
  12. Berger D, Allen G, Everett G : An assessment of the analgesic effects of nitrous oxide on the primary dentition. J Dent Child, 39:265-268, 1972.
  13. Korean Academy of Pediatric Dentistry : Pediatric, adolescent dentistry. 4th ed. Shinhung INC., 698-706, 2007.
  14. Lee WS, Song HC, Byun JS : Correlation between the observer’s assessment of alertness/sedation and the EEG-entropy during propofol infusion for sedation under spinal anesthesia. Korean J Anesthesiol, 55:399-403, 2008. https://doi.org/10.4097/kjae.2008.55.4.399
  15. Bonafe-Monzo N, Rojo-Moreno J, Catala-Pizarro M : Analgesic and physiological effects in conscious sedation with different nitrous oxide concentrations. J Clin Exp Dent, 7:63-68, 2015.
  16. Clark MS, Brunick A : Handbook of Nitrous Oxide and Oxygen Sedation, 3rd ed. Mosby, St. Louis, 2007.
  17. Leelataweewud P, Vann WF Jr, Lucas WJ, et al. : The physiological effects of supplemental oxygen versus nitrous oxide/oxygen during conscious sedation of pediatric dental patients. Pediatr Dent, 22:125-133, 2000.
  18. Kim KH, Kim JS, Kim SO : A study of the effects of sedation and related variables for pediatric dental patients. J Korean Acad Pediatr Dent, 34:234-246, 2007.