Conscious sedation in Pediatric Dentistry, combination of Midazolam and Nitrous Oxide. Literature review

Abstract

Introduction: Dental care is an experience that produces anxiety for many users, even more so in children. Therefore, conscious sedation is used as a complement to child behavior management techniques. Defined as the minimum consciousness depression where the user maintains a patent airway and is able to respond appropriately. It can be used pharmacologically, inhaled or mixed. Objective: To evaluate the current literature on the combined use of Midazolam-Nitrous Oxide as conscious sedation in Pediatric Dentistry. Material and methods: Following PRISMA guidelines, a review of the literature on the use of midazolam-nitrous oxide as dental sedation was carried out in Lilacs, Scopus and PubMed databases during 2017-2022 using as search algorithm: "conscious sedation" OR "dental sedation" OR "conscious sedation dentistry" AND "midazolam" AND "nitrous oxide" Results: 25 articles were found, 17 were selected for qualitative analysis described in the table under parameters: drug-dose, indication, results, advantages-disadvantages and adverse effects . Conclusions: Conscious sedation is of great help both for the execution of the procedure and for the professional and user, since they are awake at all times, allowing verbal interaction. Although there are no statistically significant differences between the two techniques in child cooperation, the studies would recommend the use of the combined technique since it generates a reduction in the total dose of midazolam and recovery time, thus achieving a better safety profile with an adequate level of sedation, also improving acceptance of the inhalation of nitrous oxide.