EAPD Guidelines On Sedation in Paediatric Dentistry

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EAPD Guidelines on Sedation in Paediatric Dentistry

A.-L. Hallonsten, B. Jensen, M. Raadal, J. Veerkamp, M.T. Hosey, S. Poulsen


It should be emphasized that these guidelines are only dealing
with conscious sedation, which implies that the patient has
• Minimally depressed consciousness
• Ability to maintain open airway
• Protective reflexes maintained
• Response to physical and verbal stimulation

Introduction ................................................................................................................................................... 2
Sedation in Paediatric Dentistry.................................................................................................................... 2
Need for guidelines on sedation................................................................................................................ 2
Legislation ................................................................................................................................................ 2
Restraint.................................................................................................................................................... 2
Sedation and pain control ......................................................................................................................... 2
Objectives for sedation in paediatric dentistry.......................................................................................... 2
Definitions ................................................................................................................................................ 3
Patient selection and assessment ................................................................................................................... 3
Indications and contraindications ............................................................................................................. 3
Patient monitoring .................................................................................................................................... 4
Patient information........................................................................................................................................ 4
Written and oral information and consent ................................................................................................ 4
Fasting....................................................................................................................................................... 5
Discharge .................................................................................................................................................. 5
Documentation and records........................................................................................................................... 5
Safety for the staff......................................................................................................................................... 5
Education and Training ................................................................................................................................. 6
Drugs............................................................................................................................................................. 6
Nitrous oxide ............................................................................................................................................ 6
Benzodiazepines (BZD)............................................................................................................................ 6
Other agents with sedative properties ....................................................................................................... 7
Nitrous oxide/oxygen inhalation sedation..................................................................................................... 7
Indications................................................................................................................................................. 7
Contraindications...................................................................................................................................... 7
Side effects................................................................................................................................................ 8
Dosage ...................................................................................................................................................... 8
Safety for the staff .................................................................................................................................... 8
Midazolam sedation ...................................................................................................................................... 8
Indications................................................................................................................................................. 8
Contraindications...................................................................................................................................... 8
Side effects................................................................................................................................................ 8
Clinical considerations.............................................................................................................................. 8
Routes ....................................................................................................................................................... 8
Doses......................................................................................................................................................... 9
Diazepam sedation ........................................................................................................................................ 9
Routes ....................................................................................................................................................... 9
Doses......................................................................................................................................................... 9
Appendix I................................................................................................................................................... 10
Appendix II ................................................................................................................................................. 11

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