Transcutaneous oxygen monitoring of patients undergoing nitrous oxide-oxygen sedation

The objective of this study was to assess the changes in transcutaneous oxygen tension in pediatric patients undergoing nitrous oxide-oxygen analgesia. A total of 19 healthy patients, ranging in age from 3 to 19 years with a mean age of 9.8 years, were included. Transcutaneous oxygen monitoring was performed; following stabilization, baseline readings were obtained. Oxygen was delivered at 3 I/rain for 5 min, followed at 5-min intervals by oxygen at 5 l/min, oxygen at 5 l/min with 20% nitrous oxide, oxygen at 5 l/min with 40% nitrous oxide, and finally 100% oxygen at 5 l/rain. Transcutaneous oxygen levels remained above baseline throughout the study period. There was an indication that increasing nitrous oxide concentration tended to depress somewhat he transcutaneous oxygen levels. Transcutaneous oxygen monitoring seems to offer a reliable noninvasive continuous modality of early detection of ventilation-related complications. The use of various sedation techniques in conjunction with dental treatment is a significant adjunct to modern dentistry. One of the most frequently employed sedation techniques is nitrous oxide-oxygen analgesia. 1,2 New guidelines concerning appropriate methods of monitoring sedated patients have been proposed by various dental and medical organizations. 3 The relative safety of nitrous oxide-oxygen analgesia is well established. Only minimal changes occur in pulse rate, respiration, and blood pressure. 2"4,5 The effects of nitrous oxide-oxygen analgesia on transcutaneous oxygen tension (TcPO2) have not been studied adequately. As with other sedation techniques, proper application and reliable monitoring of patients undergoing nitrous oxide-oxygen analgesia are essentialo 3 TcPO2 monitors, due to their noninvasive nature, seem ideal for monitoring dental patients. This study assesses the changes in TcPO2 in pediatric dental patients undergoing nitrous oxide-oxygen analgesia.