Jun 2026· Oral Health & Preventive Dentistry· Vol 24, pp. 473 - 479· 0 citations· 35 references
Medicine
TL;DR
Inhalation sedation with nitrous oxide and oxygen was associated with reductions in heart rate and blood pressure in hypertensive patients undergoing dental treatment, while maintaining stable oxygen saturation, and was also associated with reduced dental anxiety and facilitation of dental procedures.
Abstract
Background Several research studies reported the anxiolytic and analgesic properties of nitrous oxide sedation, as well as its effectiveness in facilitating dental procedures for anxious populations, specifically, dental patients with high blood pressure. Objective This clinical observational study aims to assess the impact of inhalation sedation using nitrous oxide mixed with oxygen on cardiovascular haemodynamics in hypertensive patients requiring dental treatment. Methods and Materials Adult dental patients with hypertension and dental anxiety who attended the dental clinic with acute dental pain were included in the study. Non-invasive blood pressure (NIBP/mmHg), heart rate (beats per min (bpm)), and oxygen saturation (SPO2%) were measured before, during, and after inhalation sedation. Participants’ dental anxiety and need for conscious sedation were measured using the Modified Dental Anxiety Scale and the Indicator of Sedation Need, respectively. Dental procedure characteristics and sedation details were also collected, such as procedure type and duration, number of visits, and nitrous oxide concentration. Results Significant reductions in heart rate and blood pressure were observed during and after the procedure compared with baseline. Mean heart rate decreased from pre-sedation to intraprocedural and post-procedural phases, while blood pressure shifted from pre-hypertensive or hypertensive levels to normal in most participants during and after sedation. Respiratory rate remained stable, and oxygen saturation was maintained at optimal levels throughout all phases. Conclusion Inhalation sedation with nitrous oxide and oxygen was associated with reductions in heart rate and blood pressure in hypertensive patients undergoing dental treatment, while maintaining stable oxygen saturation. It was also associated with reduced dental anxiety and facilitation of dental procedures. These findings suggest a potentially beneficial role for inhalation sedation in this population; however, causal inferences are limited by the observational study design.
Intravenous sedation is optimal for profound anxiolysis in complex cases, while nitrous oxide is ideal for routine procedures, prioritizing rapid recovery and fewer side effects.
M. Nahar, Md Toufiqur Rahman, Mohammad Ataul Hasan et al.· Community Based Medical Jour...· 0 citations
Both the groups resulted in acceptable, efficient and safe outcomes with no much difference in the brain activity levels, according to the findings of the present study.
N. R. Ghongade, Namrata Gaonkar· Journal of Clinical and Diag...· 0 citations
Background: Dental anxiety and uncooperative behavior are common challenges in pediatric dentistry and can
negatively affect treatment outcomes and future dental attendance. Sedation techniques are frequently employed
to reduce anxiety, improve cooperation, and enhance children's overall dental experience. However, evidence
comparing the impact of different sedation techniques on children's experience and compliance remains limited.
Objective: To compare the effects of inhalation sedation and oral sedation on children's experience and
compliance during dental procedures.
Methods: This prospective comparative observational study included 100 children aged 4–10 years requiring
dental treatment under sedation. Participants were divided into two groups: Group A (n = 50) received inhalation
sedation with nitrous oxide–oxygen, and Group B (n = 50) received oral sedation. Children's experience was
assessed post-procedure using a facial image scale, while compliance during treatment was evaluated using the
Frankl Behavior Rating Scale. Demographic and clinical variables were recorded. Data were analyzed using
descriptive statistics, chi-square tests, and logistic and ordinal regression analyses using STATA, with p < 0.05
considered statistically significant.
Results: Children in the inhalation sedation group demonstrated significantly higher rates of positive experience
and cooperative behavior compared to the oral sedation group. Logistic regression analysis showed that inhalation
sedation significantly increased the odds of cooperative behavior. Ordinal regression analysis also indicated a
significant association between inhalation sedation and improved experience scores, independent of age and
gender.
Conclusion: Inhalation sedation was more effective than oral sedation in improving children's dental experience
and compliance during procedures. These findings support the preferential use of inhalation sedation as a behavior
management strategy in pediatric dentistry
Isha Tewary, P. Samir, Esta F Thattil et al.· International Journal of Dru...· 0 citations
Introduction: Spinal anaesthesia commonly causes hypotension due to sympathetic blockade. Controlled hypertensive patients may exhibit altered cardiovascular responses because of vascular and autonomic changes. Evidence comparing hypertensive and normotensive patients remains inconsistent. This study aimed to comparatively evaluate hemodynamic changes following spinal anaesthesia to improve perioperative risk stratification and management.Material and Method: This comparative observational study included 120 American Society of Anesthesiologists physical status (ASA) I–III patients (40–75 years) undergoing elective infraumbilical surgeries under spinal anaesthesia. Patients were grouped as controlled hypertensive or normotensive. Standardized spinal technique and monitoring were used. Hemodynamic variables were recorded up to 30 minutes. Hypotension was predefined and managed accordingly. Statistical analysis included t-test, ANOVA, Chi-square, and Pearson correlation.Result:A total of 120 patients undergoing spinal anaesthesiawere studied i.e. 60 Controlled hypertensive patients (CHT) and 60 normotensive (NT) with comparable demographics and surgical characteristics. Controlled hypertensive patients had higher baseline mean arterial pressure, systolic and diastolic blood pressure and experienced greater maximum hemodynamic declines. Hypotension (48.3% vs 28.3%) and vasopressor requirement were significantly higher in CHT patients. Advanced age, elevated baseline pressures, higher sensory block, increased body mass index (BMI), and longer surgery predicted hypotension.Conclusion: Controlled hypertensive patients experience greater hemodynamic instability following spinal anaesthesia compared to normotensive individuals, with higher incidence and earlier onset of hypotension and increased vasopressor requirement. Careful monitoring and individualized perioperative management are essential to improve safety and outcomes.
Dinesh Makkar, Daya Ram, Vijay Kumar· Asian Journal of Medical Res...· 0 citations
OBJECTIVE
This research aimed to evaluate the effect of sevoflurane combined with mivacurium chloride (MC) and positive pressure ventilation by a laryngeal mask airway in adult patients undergoing general anesthesia.
METHODS
This retrospective study included 88 adult patients who underwent surgery under general anesthesia induced with sevoflurane, MC, and fentanyl. Based on the anesthesia method documented in medical records, patients were divided into an endotracheal general anesthesia (EGA) group (n=44) and a laryngeal mask airway general anesthesia (LMAGA) group (n=44).
RESULTS
The LMAGA group had lower heart rate, mean arterial pressure, end-tidal carbon dioxide, and cortisol levels than the EGA group (P < 0.05). Time to loss of eyelash reflex, extubation time, and awakening time were significantly shortened in the LMAGA group (P < 0.05). In the LMAGA group, postoperative time to first ambulation and first oral intake was significantly less than that in the EGA group (P < 0.05). Bispectral index values and Narcotrend index at the defined time points T2 and T5 were significantly higher in the EGA group (P < 0.05). The LMAGA group had a lower complication rate than the EGA group (P < 0.05) and exhibited better postoperative cognitive status (P < 0.05).
CONCLUSION
Sevoflurane combined with MC provides a better anesthetic effect and a favorable safety profile.
Xiaojie Gong, Rui Fu, Manman Zhang· American journal of translat...· 0 citations
Introduction Patients with intellectual disabilities, autism spectrum disorder, and related conditions often require sedation or general anesthesia to receive dental treatment. Many of these patients routinely take multiple medications, including antiepileptic and antipsychotic drugs, which may influence anesthetic management through drug interactions. However, medication use among patients receiving dental anesthesia in special needs dentistry has not been well investigated. This study aimed to clarify patterns of oral medication use in this population. Methods This retrospective descriptive study included patients who underwent dental treatment under general anesthesia or intravenous sedation at Okayama University Hospital, Japan, between April 2022 and March 2025. Demographic characteristics, anesthesia-related variables, and regularly prescribed oral medications were collected from electronic medical records. Medications were categorized by pharmacological class, and descriptive statistical analyses were performed. Results A total of 424 patients were analyzed. The mean age was 27.6 ± 15.3 years, and 67.4% were male. General anesthesia was used in 70.5% of patients. Overall, 71.0% regularly used oral medications, and polypharmacy, defined as the use of five or more medications, was observed in 23.5%. Antiepileptic drugs (36.8%) and antipsychotics (35.4%) were the most frequently prescribed medication classes. Risperidone and sodium valproate were the most commonly prescribed medications. Conclusion Despite the relatively young age of the study population, medication use and polypharmacy were highly prevalent. The frequent use of antiepileptic and antipsychotic medications highlights the importance of understanding potential drug interactions during anesthetic management in special needs dentistry.
H. Higuchi, Natsumi Naoi, K. Noda et al.· Frontiers in Oral Health· 0 citations