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Use of sedation analgesia for pediatric dentistry
R K Sharma1, R R Pinto, N N Mirchandani
1Department of Anasthesia, T.N. Medical College & B.Y.L. Nair Ch. Hospital, Bombay, India.
Insights
Regimen II, combining Triclofos elixir and promethazine elixir, improved behavior management in young children during dental procedures compared to Triclofos alone. However, extremely anxious children did not benefit from this sedation technique.
Area of Science:
- Pediatric Dentistry
- Sedation in Dentistry
- Behavior Management
Background:
- Effective behavior management is crucial for pediatric dental care.
- Sedation techniques are often employed to facilitate treatment for young children.
- Triclofos elixir and promethazine are commonly used sedatives.
Purpose of the Study:
- To compare the efficacy of Triclofos elixir alone versus Triclofos elixir combined with promethazine elixir for behavior management in young children undergoing dental procedures.
- To evaluate the impact of these sedative regimens on vital signs, sedation, sleep, movement, crying, and overall behavior.
Main Methods:
- A double-blind, randomized study involving 26 healthy children aged 36-60 months.
- Participants received either Triclofos elixir (Regimen I) or Triclofos elixir with promethazine elixir (Regimen II).
- All subjects received 35% nitrous oxide/oxygen and were restrained in a papoose board; vital signs and behavior were monitored.
Main Results:
- Regimen II demonstrated superior behavior management compared to Regimen I for difficult young children.
- No significant differences were noted in other monitored parameters between the two regimens.
- Extremely apprehensive children were not suitable candidates for this sedation approach.
Conclusions:
- Combination of Triclofos elixir and promethazine elixir is an effective strategy for managing behavior in challenging pediatric dental patients.
- Further research may be needed to identify optimal sedation techniques for highly anxious children.
- This study highlights the importance of tailored sedation approaches in pediatric dentistry.
Abstract:
26 healthy children between the ages of 36 and 60 months (mean 35 months) who satisfied the selection criteria during a screening visit participated in this double blind study. The subjects were assigned randomly to receive either 75 mg/kg Triclofos elixir (Regimen I-21 children) or 50 mg/1kg Trichlofos elixir combined with 1 mg/kg promethazine elixir (Regimen II-22 children). All medications were given orally 45 minutes before treatment. During operative procedures all subjects received nitrous oxide/oxygen at a concentration of 35%. All the patients were restrained in a papoose board (Indigenous). The subjects were monitored for vital signs and evaluated for sedation and sleep, movement, crying and overall behaviour before, during and after the operative procedure. Regimen II was found to be superior to Regimen I with regard to behaviour management of difficult young children. However extremely apprehensive children were not good subjects for this sedation technique.