NITROUS OXIDE OR MIDAZOLAM TO TOOTH EXTRACTION? A SYSTEMATIC REVIEW
DOI:
https://doi.org/10.25110/arqsaude.v27i5.2023-013Palavras-chave:
Dental Anxiety, Tooth Extraction, Anesthetics, Conscious SedationResumo
Aim: This systematic review aimed to evaluate the use of midazolam and nitrous oxide in conscious sedation for dental extraction procedures. Methods: A search was conducted in electronic searches Medline/PubMed, Embase, Cochrane Library, Web of Science, grey literature, and the main scientific journals in the area, following PRISMA. Booleans operators were used for the combinations of terms and the search strategy was adapted to each of the databases, (“tooth extraction” OR “molar, third” OR “tooth, impacted” OR “surgery, oral” OR “exodontics” OR “wisdom tooth” AND “nitrous oxide” OR “anesthetics, inhalation” OR “conscious sedation” OR “laughing gas” OR “moderate sedation” AND “midazolam” OR “benzodiazepines” OR “hypnotics and sedatives” OR “sedative effect”). Study Selection and Data Extraction: The inclusion criteria were parallel and crossover RCTs involving patients of any age submitted to tooth extraction at a dental office under local anesthesia. No language restrictions have been imposed until 2023. The exclusion criteria were studies involving patients submitted to extraction in the hospital setting, studies that did not measure anxiety or sedation and studies for which the full text was not available. Results: Where within the eight articles that met the eligibility criteria, no significant differences were found between the methods, in relation to sedation or anxiety. Conclusion: In conclusion, nitrous oxide and midazolam safely ensure good levels of sedation and anxiety control, being pharmacological approaches possible to be used in dental care, even in those more invasive such as, tooth extraction.
Referências
MELINI, M.et al. Conscious sedation for the management of dental anxiety in third molar extraction surgery: a systematic review. BMC oral health, v. 20, n. 1, p. 155. 2020 https://doi.org/10.1186/s12903-020-01136-0
WATANABE, Y., et al. Effect of a low dose of midazolam on high blood pres-sure in dental patients: a randomised, double-blind, placebo-controlled, two-centre study. The British journal of oral & maxillofacial surgery, v. 54, n. 4, p. 443–448, 2016. https://doi.org/10.1016/j.bjoms.2016.02.006
CHEN, Q., et al. The anxiolytic effect of midazolam in third molar extraction: a systematic review. PloS one, v. 10, n. 4, e0121410, 2015. https://doi.org/10.1371/journal.pone.0121410
PEREIRA-SANTOS, D., et al. Study comparing midazolam and nitrous oxide in dental anxiety control. The Journal of craniofacial surgery, v. 24, n. 5, p. 1636–1639, 2013. https://doi.org/10.1097/SCS.0b013e3182a15dfc
ASTRAMSKAITĖ, I., POŠKEVIČIUS, L., JUODŽBALYS, G. Factors deter-mining tooth extraction anxiety and fear in adult dental patients: a systematic review. International journal of oral and maxillofacial surgery, v. 45, n. 12, p. 1630–1643, 2016. https://doi.org/10.1016/j.ijom.2016.06.019
DE MOARES, M. B., et al. Comparison of Three Anxiety Management Proto-cols for Extraction of Third Molars With the Use of Midazolam, Diazepam, and Nitrous Oxide: A Randomized Clinical Trial. Journal of oral and maxillofacial surgery: offi-cial journal of the American Association of Oral and Maxillofacial Surgeons, v. 77, n. 11, p. 2258.e1–2258.e8, 2019. https://doi.org/10.1016/j.joms.2019.06.001
GARIP, H., et al. Anxiety and extraction of third molars in Turkish patients. The British journal of oral & maxillofacial surgery, v. 42, n. 6, p. 551–554, 2004. https://doi.org/10.1016/j.bjoms.2004.08.001
MHATRE, A. S., PANIGRAHI, S., PAWAR, S., B. A Comparative Study Be-tween Oral Midazolam And Nitrous Oxide-Oxygen For Dental Extractions In Paediat-ric Patients. J. Evol. Med. Dent. Sci, v.7, n. 34, p. 3744-3749, 2018. doi: 10.14260/jemds/2018/841.
link.gale.com/apps/doc/A556229417/HRCA?u=googlescholar&sid=googleScholar&xid=a526a0f8. Accessed 8 Apr. 2023.
MORAIS, H. H. A., et al. Comparative study of hemodynamic changes caused by diazepam and midazolam during third molar surgery: a randomized controlled trial. Oral Maxillofac Surg, v. 19, n. 3, p. 267-273, 2015. DOI: 10.1007/s10006-015-0488-3
VENCHARD, G. R., THOMSON, P. J., BOYS, R. Improved sedation for oral surgery by combining nitrous oxide and intravenous Midazolam: a randomized, con-trolled trial. Int J Oral Maxillofac Surg, v. 35, n. 6, p. 522-527, 2006. DOI: 10.1016/j.ijom.2005.11.003.
OLIVEIRA, M. L. R. S. de; ARAÚJO, S. M.; BOTTAN, E. R. Ansiedade ao tratamento odontológico: perfil de um grupo de adultos em situação não clínica. Arq. Cienc. Saúde UNIPAR, Umuarama, v. 19, n. 3, p, 165-170, set./dez. 2015.
WILSON, K. E., GIRDLER, N. M., WELBURY, R. R. Randomized, con-trolled, cross-over clinical trial comparing intravenous midazolam sedation with nitrous oxide sedation in children undergoing dental extractions. Br J Anaesth, v. 91, n. 6, p. 850-856, 2003. DOI: 10.1093/bja/aeg278.
JERJES, W., et al. Midazolam in the reduction of surgical stress: A randomized clinical trial. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, v. 100, n. 5, p. 564-570, 2005. DOI: 10.1016/j.tripleo.2005.02.087.
ONG, K. S., SEYMOUR, R. A., TAN, J. M. L. A prospective randomized crossover study of the preemptive analgesic effect of nitrous oxide in oral surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, v. 98, n. 6, p. 637-642, 2004. DOI: 10.1016/j.tripleo.2004.02.078.
PAGE, M. J., et al. The PRISMA 2020 statement: an updated guideline for re-porting systematic reviews. BMJ, v. 372:n71, 2021. DOI:10.1136/bmj.n71.
HIGGINS, J., THOMAS, J., EDS.: Cochrane Handbook for Systematic Reviews of Interventions. Version 6.2. 2021.
MOHER, D., et al. PRISMA. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med, v.6, n. 7, e1000097, 2009. DOI:10.1371/journal.pmed1000097.
WILSON, K. E., WELBURY, R. R., GIRDLER, N. M. Randomised, con-trolled, crossover trial of oral midazolam and nitrous oxide for paediatric dental seda-tion. Anaesthesia, v. 57, n. 9, p. 860-867, 2002. DOI: 10.1046/j.1365-2044.2002.02784.x.
WILSON, K. E., WELBURY, R. R., GIRDLER, N. M. Comparison of trans-mucosal midazolam with inhalation sedation for dental extractions in children. A ran-domized, cross-over, clinical trial. Acta Anaesthesiol Scand, v. 51, n. 8, p. 1062‐1067, 2007. DOI: 10.1111/j.1399-6576.2007.01391.x.
STERNE, J. A. C., et al. RoB 2: a revised tool for assessing risk of bias in ran-domised trials. BMJ, v. 366, p. l4898, 2019. DOI: 10.1136/bmj.l4898.
EGGER, M., SMITH, G. D. Principles of and procedures for systematic reviews. In: EGGER, M., SMITH, G. D., ALTMAN, A. G., EDS.: Systematic Reviews in health care: meta-analysis in context. Londres: BMJ Books, p. 23-42, 2001. https://DOI.org/10.1002/9780470693926.ch2.
SCHÜNEMANN, H., et al. eds.: GRADE handbook for grading quality of evi-dence and strength of recommendations. Updated October 2013. https://gdt.gradepro.org/app/handbook/handbook.html. [accessed 01/02/2021]
SCHULZ, K. F., ALTMAN, D. G., DAVID, M., CONSORT Group. CON-SORT 2010 Statement: updated guidelines for reporting parallel group randomised tri-als. BMJ, v. 340, p. c332, 2010. DOI: 10.1136/bmj.c332.
GAMBA, C. G. Avaliação da eficácia de dois protocolos farmacológicos de con-trole da ansiedade em um centro de especialidades odontológicas (CEO). Piracicaba: Universidade Estadual de Campinas, 2008.
WILSON, K. E., GIRDLER, N. M., WELBURY, R. R. A comparison of oral midazolam and nitrous oxide sedation for dental extractions in children. Anaesthesia, v. 61, n. 12, p. 1138‐1144, 2006. DOI: 10.1111/j.1365-2044.2006.04835.x.
HULLAND, S. A., FREILICH, M. M., SÀNDOR, G. K. B. Nitrous oxide-oxygen or oral midazolam for pediatric outpatient sedation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, v. 93, n. 6, p. 643-6, 2002. Doi: 10.1067/moe.2002.124763.
ANDRADE, E. D. Terapêuticas medicamentosa em odontologia. São Paulo: Artes Médicas, 1998.
SIVARAMAKRISHNAN G, SRIDHARAN K. Nitrous Oxide and Midazolam Sedation: A Systematic Review and Meta-Analysis. Anesth Prog, v. 64, n.2, p.59-65,2017. Doi:10.2344/anpr-63-03-06
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Os Direitos Autorais para artigos publicados são de direito da revista. Em virtude da aparecerem nesta revista de acesso público, os artigos são de uso gratuito, com Creative Commons Attribution 4.0 International License.
A revista se reserva o direito de efetuar, nos originais, alterações de ordem normativa, ortográfica e gramatical, com vistas a manter o padrão culto da língua e a credibilidade do veículo. Respeitará, no entanto, o estilo de escrever dos autores.
Alterações, correções ou sugestões de ordem conceitual serão encaminhadas aos autores, quando necessário. Nesses casos, os artigos, depois de adequados, deverão ser submetidos a nova apreciação.
As opiniões emitidas pelos autores dos artigos são de sua exclusiva responsabilidade.
