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Pré-medicação oral em sedação consciente com protóxido de azoto
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O controlo de comportamento de crianças não cooperantes é frequentemente atingido com técnicas de sedação farmacológica. A sedação por via oral é uma das vias de sedação mais antiga e já provou permitir um bom controlo da ansiedade pré-operatória. Nos fármacos orais mais utilizados em medicina dentária podemos encontrar as benzodiazepinas, a hidroxizina e o hidrato de cloral. A sedação por via inalatória, nomeadamente a mistura de protóxido de azoto com oxigénio aproxima-se do ideal principalmente porque permite controlar o nível de sedação não deixando praticamente resíduos no corpo. No entanto, os seus resultados não são constantes. A combinação de pré-medicação oral em sedação consciente com protóxido de azoto tem como objectivos potenciar as vantagens e colmatar as falhas de cada uma destas vias. As combinações de pré-medicação oral/protóxido de azoto mais comuns incluem o diazepam/protóxido de azoto, midazolam/protóxido de azoto, hidrato de cloral/protóxido de azoto e hidroxizina/protóxido de azoto. Numa revisão dos artigos que abrangem este tema verificou-se que todas as combinações diazepam/protóxido de azoto, midazolam/protóxido de azoto, hidrato de cloral/protóxido de azoto são seguras e eficazes no controlo de comportamento, através do controlo do movimento, do choro e da sonolência das crianças durante o tratamento dentário. Porém, não se encontraram estudos suficientes que permitissem uma apreciação justa do desempenho da combinação hidroxizina/protóxido de azoto no controlo de comportamento da criança. São necessários mais estudos que comparem as várias combinações de medicamentos entre si.
Behavior management of the uncooperative children frequently requires pharmacological sedation techniques. Oral sedation is one of the oldest routes of administration and has proven to provide a good control of pre-operative anxiety. The most frequent oral drugs in dentistry are the benzodiazepines, hydroxyzine and chloral hydrate. The inhalation route with nitrous oxide and oxygen is practically a perfect sedation because it allows the control of the sedation’s level e leaves practically no traces. However, the results aren’t constants. The combination of oral premedication and nitrous oxide intents to enhance the vantages and overcome the disadvantages of which route. The most frequent combinations of premedication/nitrous oxide include diazepam/nitrous oxide, midazolam/nitrous oxide, hydroxyzine/nitrous oxide and chloral hydrate/nitrous oxide. The articles review that comprehend the theme showed that diazepam/nitrous oxide, midazolam/nitrous oxide and chloral hydrate/nitrous oxide combinations are effective in the management of children’ movement, cry and sleep during dental treatment. They’ve shown to be safe and effective in behavior management. They weren’t found enough articles that allowed reasonable considerations about hydroxyzine/nitrous oxide combination in children’ behavior management. It would be useful more comparative studies between the various combinations.
Behavior management of the uncooperative children frequently requires pharmacological sedation techniques. Oral sedation is one of the oldest routes of administration and has proven to provide a good control of pre-operative anxiety. The most frequent oral drugs in dentistry are the benzodiazepines, hydroxyzine and chloral hydrate. The inhalation route with nitrous oxide and oxygen is practically a perfect sedation because it allows the control of the sedation’s level e leaves practically no traces. However, the results aren’t constants. The combination of oral premedication and nitrous oxide intents to enhance the vantages and overcome the disadvantages of which route. The most frequent combinations of premedication/nitrous oxide include diazepam/nitrous oxide, midazolam/nitrous oxide, hydroxyzine/nitrous oxide and chloral hydrate/nitrous oxide. The articles review that comprehend the theme showed that diazepam/nitrous oxide, midazolam/nitrous oxide and chloral hydrate/nitrous oxide combinations are effective in the management of children’ movement, cry and sleep during dental treatment. They’ve shown to be safe and effective in behavior management. They weren’t found enough articles that allowed reasonable considerations about hydroxyzine/nitrous oxide combination in children’ behavior management. It would be useful more comparative studies between the various combinations.
Descrição
Tese de mestrado, Medicina Dentária, Universidade de Lisboa, Faculdade de Medicina Dentária, 2012
Palavras-chave
Anestesia oral Teses de mestrado - 2012