Sedation with nitrous oxide and oxygen in combination with other drugs in pediatric dentistry.

Abstract

Introduction: Dental treatment in non-cooperative child patients can become a challenge when behavioral management does not reduce anxiety and control pain. Therefore, pharmacological management is necessary to carry out an effective and safe treatment. Objective: To evaluate the literature on the association of nitrous oxide with other pharmacological agents in pediatric dental patients. Literature review: A search was carried out in electronic databases: PubMed, Scopus and Web of Science. Keywords “nitrous oxide”, “dentistry”, “pediatric patient”, “sedation” were used, considering studies published in spanish, english and portuguese published from 2019 to 2024. Conclusions: Nitrous oxide is an alternative in treatments to reduce anxiety, it has demonstrated effectiveness in equimolar concentrations with oxygen, but it can also be effective at concentrations greater than 50% in sedation of pediatric dental patients. By combining it with other drugs such as midazolam, fentanyl, dexmedetomidine, it allows its concentration dose to be reduced with other drugs, presenting favorable results especially in children over 3 years of age. Most studies associate nitrous oxide with oral midazolam (0.50-0.75 mg/kg), considering it a safe combination in child patients. Recommendations: It is recommended to carry out new studies that associate nitrous oxide at different concentrations with other drugs with different doses, also that evaluate the level of sedation on different scales, as well as the patient's cooperation.