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Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
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Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea

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Nitrous oxide sedation and bispectral index

Berrin Işik1, Tamer Tüzüner, Melih Tezkirecioglu

  • 1Anesthesiology and Reanimation Specialist, Gazi University, Faculty of Dentistry, Department Oral and Maxillofacial Surgery, Ankara, TURKEY.

European Journal of Dentistry
|February 13, 2009
PubMed

Insights

Bispectral analysis (BIS) monitoring did not show changes in anxious children receiving nitrous oxide (N2O) sedation for primary tooth extractions. BIS is not suitable for assessing N2O/O2 sedation depth in pediatric dental procedures.

Area of Science:

  • Pediatric Dentistry
  • Anesthesiology
  • Neuroscience

Background:

  • Anxious children undergoing dental procedures often require sedation.
  • Nitrous oxide (N2O)/oxygen (O2) is a common sedative agent.
  • Assessing sedation depth is crucial for patient safety.

Purpose of the Study:

  • To investigate changes in Bispectral Analysis (BIS) during nitrous oxide (N2O) sedation.
  • To evaluate the suitability of BIS monitoring for assessing sedation depth in children.
  • Focus on anxious children undergoing primary tooth extraction.

Main Methods:

  • Prospective study of 40 ASA physical status I children (7-12 years old).
  • Recorded BIS levels, Ramsay Sedation Scores (RSS), SpO2, and HR at 1-minute intervals.
  • Administered 40-60% N2O in O2 via nasal hood, paired with Observer's Assessment of Alertness and Sedation (OAA/S) scores.

Main Results:

  • Nitrous oxide inhalation did not alter BIS levels.
  • Sedation was achieved, as indicated by OAA/S scores.
  • No correlation found between BIS values and observed sedation levels.

Conclusions:

  • Bispectral analysis (BIS) values remain unchanged during N2O/O2 sedation in children.
  • The BIS monitor is not an appropriate tool for evaluating the depth of N2O/O2 sedation.
  • This finding is relevant for pediatric dental extractions requiring sedation.
Abstract

Keywords:
AnxietyBispectral indexNitrous oxide sedationRamsay sedation scale

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