Oxygen Saturation and Pulse Rate Change in Children during Sedation with Oral Midazolam and Nitrous Oxide

Area of Science:

• Pediatric Dentistry
• Anesthesiology
• Sedation Monitoring

Background:

• Conscious sedation is frequently used in pediatric dentistry.
• Midazolam and nitrous oxide are common agents for pediatric conscious sedation.
• Understanding factors influencing physiological responses during sedation is vital for patient safety.

Purpose of the Study:

• To investigate the association between pediatric patient behavior and physiological changes during conscious sedation.
• To determine if midazolam dose, treatment type, duration, or demographics impact oxygen saturation and pulse rate.
• To analyze the relationship between behavior and vital signs in children undergoing dental treatment with midazolam and nitrous oxide.

Main Methods:

• Retrospective chart review of 147 pediatric patients (ages 2.5-12.5 years).
• Conscious sedation administered with oral midazolam (0.4-0.5 mg/kg or max 10 mg) +/- nitrous oxide for dental treatment.
• Monitoring of pulse rate and oxygen saturation every 15 minutes during sedation.

Main Results:

• Children with poor behavior scores exhibited significantly higher mean pulse rates (p=0.0001) compared to those with good/excellent behavior.
• Oxygen saturation levels, though statistically different (p<0.012), remained within normal ranges for children with poor behavior.
• Treatment duration, dental procedure type, and patient weight did not correlate with changes in oxygen saturation or pulse rate.

Conclusions:

• Poor behavior in pediatric patients under midazolam and nitrous oxide sedation is linked to an increased pulse rate.
• Oxygen saturation is not significantly affected by poor behavior in this sedation context.
• These findings aid in refining sedation protocols and managing patient behavior during dental procedures.