Paediatric Sedation

Question 1

What is a paediatric anxiety assessment tool?

Answer 1

MCDASf
Adapted faces version of modified dental anxiety scale
Score 9-45
Extreme dental anxiety/phobia= >31 or 5/5 for any question

Question 2

What are the indications for IS in children?

Answer 2

Age (has to understand concept of nasal breathing)
Anxiety level (mild to moderate anxiety, good for phobia of needles)
Management of gag reflex (hyperreactive gag reflex)
Medical considerations
Previous dental history

Question 3

What are the contraindications for IS in children?

Answer 3

Age (over 4 yrs old, cannot understand IS concept)
Anxiety - extreme
Medical considerations
–nasal blockage, severe psychiatric disorders, mysasthenia gravis, cannot understand nose breathing or hypnotic suggestion

Question 4

What IV drug is used in children?

Answer 4

Propofol

Question 5

What are the indications for IV sedation?

Answer 5

12 or older
Moderate to severe anxiety (general dental phobia)
Dental needs
–high volume of treatment needed
–surgical difficulty of a procedure

Question 6

What are the contraindications of IV sedation in children?

Answer 6

Younger than 12
Severe needle phobia
Intellectual impairment- cannot understand what is going on

Question 7

What is TCI propofol?

Answer 7

Target-controlled infusion (TCI) sedation
Propofol is a potent IV anaesthetic agent used in a low dose for IV sedation

Question 8

How is TCI Propofol delivered?
Mechanism of action?

Answer 8

Delivery by computer driven target controlled infusion designed to achieve and maintain a pre-set plasma concentration of propofol
Plasma propofol rapidly equilibrates with the brain and the sedatonist can continuously titrate the concentration against level of sedation