Effect of nitrous oxide-oxygen inhalation with scavenging on behavioral and physiological parameters during routine pediatric dental treatment.

PURPOSE The purpose of this study was to determine the influence of 40% nitrous oxide/60% oxygen inhalation with scavenging on the behavioral and physiological parameters during routine pediatric dental procedures. METHODS Twenty-two subjects, aged 60-116 months, were randomized into a double blind, cross-over study design and administered alternately either 40% nitrous oxide/60% oxygen or 100% oxygen during two sequential restorative appointments. All subjects were monitored continuously for respiratory rate, pulse rate, and hemoglobin oxygen saturation using a combined capnograph and pulse oximeter. The subject's breath sound and behavior were recorded every minute along with vital signs. RESULTS When compared to 100% oxygen inhalation, 40% nitrous oxide/60% oxygen inhalation produced significant reductions in adverse patient behavior, respiratory rate, and pulse rate, but did not affect percent hemoglobin oxygen saturation. Nitrous oxide inhalation had no effect on breath sound revealed by auscultation or on the occurrence of the apnea alarm displayed by the capnograph. CONCLUSIONS This study demonstrated that the administration of 40% nitrous oxide/60% oxygen delivered via a scavenging nasal hood significantly improved patient behavior and altered physiological parameters commonly monitored during conscious sedation.