Dental treatments under sedation-analgesia in patients who are unable to collaborate: a prospective observational study

doi:10.17245/jdapm.2024.24.3.173

Q2 · DentistryImpact Factor · 1.908

AutoresCarlos Cobo-Vázquez, Milena Gasco

Por qué importa

Este estudio prospectivo observacional aborda la necesidad de sedoanalgesia en pacientes con dificultades de colaboración durante tratamientos dentales, ya sea por miedo excesivo o discapacidad intelectual. Se analizaron 218 pacientes, registrando datos demográficos, patologías orales y sistémicas, intervenciones y técnicas anestésicas. Los hallazgos indican que la combinación de propofol y fentanilo fue la técnica más empleada en casos de discapacidad o procedimientos complejos, mientras que el óxido nitroso y midazolam se prefirieron para tratamientos más sencillos o pacientes jóvenes. Comprender estas opciones de manejo es crucial para ofrecer atención dental segura y efectiva a poblaciones con necesidades especiales, mejorando la experiencia del paciente y permitiendo la realización de procedimientos necesarios que de otro modo serían inviables.

Abstract original

Background: Excessive fear of dental procedures leads to disruptive behavior during dental examinations and treatments. Dental examinations and treatments of these patients usually require additional techniques, such as sedation. The most commonly used techniques are inhalation of nitrous oxide, infusion of propofol with fentanyl, and premedication and infusion of midazolam. Methods: A prospective observational epidemiological study was conducted on patients who required sedoanalgesia techniques for dental exploration and procedures. The reasons for the inability of patients to cooperate (excessive fear or intellectual disability), age, sex, weight, systemic pathology, oral pathology, treatment performed, time of intervention, anesthetic technique performed, and occurrence of complications were recorded. Results: In total, 218 patients were studied. Sixty-five patients came for fear of dental treatment and 153 for presenting with a diagnosis of intellectual disability and not collaborating in the treatment with local anesthesia. The average age of all patients was 30.54 ± 17.30 years. The most frequent oral pathologies found in patients with excessive fear were tartar (6.8%) and wisdom teeth (6.4%), followed by missing teeth (5%). In patients with disabilities, a combination of tartar and cavities appeared most frequently (41.3%), followed by cavities (15.6%). The most frequently used sedoanalgesia technique was the infusion of propofol with fentanyl in both groups of patients, followed by nitrous oxide. Conclusion: The combination of propofol and fentanyl was the most frequently used alternative in patients who were unable to collaborate because of intellectual disability or carry out longer or more complex treatments. Inhaled nitrous oxide and midazolam were the sedative techniques of choice for simpler oral treatments, such as tartrectomies, shallow obturations, and shorter interventions, or in younger patients.

Leer texto completo ↗DOI · 10.17245/jdapm.2024.24.3.173

Autor Doctor&Cols

Carlos M. Cobo Vázquez
Cirugía Oral e Implantología

Cómo citar

Cobo-Vázquez C, Gasco M. Dental treatments under sedation-analgesia in patients who are unable to collaborate: a prospective observational study. Journal of Dental Anesthesia and Pain Medicine. 2024. doi:10.17245/jdapm.2024.24.3.173