THE USE OF INHALATION SEDATION AND LOCAL-ANESTHESIA AS AN ALTERNATIVETO GENERAL-ANESTHESIA FOR DENTAL EXTRACTIONS IN CHILDREN

Objective To determine the extent to which inhalation sedation might r eplace general anaesthesia for extractions in children and assess the success rate, cost and parental reaction in comparison to general anae sthesia. Design A matched pair design. Setting Unit of Paediatric Dent istry at the University Dental Hospital of Manchester, UK between Dece mber 1992 and lune 1994. Subjects and methods Subjects aged 3 to 16 ye ars who had been referred for extractions under general anaesthesia we re used. Data were recorded for each visit and parents were asked to c omplete a simple post-operative questionnaire. Outcome Treatment succe ss was defined as completion of all treatment planned for the patient. Relative costs were derived from the time taken and staff costs. Resu lts 265 subjects, mean age 7.63 (+/-2.45) years had treatment attempte d with sedation of whom 221(83,4%) completed successfully. Young age, multiple extractions and irregular dental attendance predisposed to tr eatment failure, whereas orthodontic extractions had a similar success rate (97.6%) to general anaesthesia. The cost of sedation was less; p arental reaction to sedation was also significantly better. Conclusion Inhalation sedation can be used for many children referred for genera l anaesthesia. Greater use of this technique in the primary sector is needed to reduce the number of child referrals for general anaesthesia .