den 103 - nitrous oxide class 1

the stage during which a patient is relaxed and fully conscious

-pt can keep mouth open without assistance and can follow directions

-sense of euphoria and reduction in pain

-normal vital signs

-analgesia

stage I anesthesia

excitement - stage in which the pt is less aware of immediate surroundings and may start to become unconscious

-pt may become excited and unmanageable

-undesirable stage

stage II anesthesia

general anesthesia is the stage the begins when the patient calms

-feels no pain or sensation

-soon becomes unconscious

-only under guidance of anesthesiologist in controlled setting

stage III anesthesia

respiratory failure or cardiac arrest occurs when the lungs and heart slow down or stop functioning

-if not reversed quickly patient can die

stage IV anesthesia

monitoring means:

observation of the patient during the flow of sedation agents and includes reducing the flow or shutting off equipment

monitoring does not include:

increasing the flow of sedation agents

nitrous oxide and oxygen was discovered by?

joseph preistly

first to inhale nitrous oxide and was first to observe its analgesic effects

humphry davy

the first dentist _____ realized nitrous oxide had a pain killing effect and is recognized as the "father of anesthesia"

horace wells

established the need to mix oxygen and nitrous oxide for use in operations of long duration?

edmund andrews

dentist who invented the first nitrous oxide machine

charles teter

first fail safe system was marketed

-stops flow when oxygen drops below 30 percent

-prevents nitrous when greater than 70 percent

1976

combo of gases inhaled to help eliminate fear and aid relaxation

nitrous oxide/oxygen

over __% of dental offices in the US use nitrous oxide to provide painless and anxitey free treatment

30

it is estimated that ___ million americans postpone or avoid dental treatment due to fear and anxiety

35

tends to be a short-lived phenomenon, disappearing when the external danger of threat passes

-includes a feeling that something terrible is going to happen

fear

a specific unpleasureable state of tension which indicates the presence of some danger to the organism

-feeling of apprehension caused by an anticipation of danger

anxiety

nitrous oxide is also called?

laughing gas

what are the causes of our patient's fear of dentistry?

fear of:

-pain

-unknown

-helplessness and dependency

-bodily change and mutilation

-death

-unpleasant sensory and emotional experience arising from actual or potential tissue damage

-provides damage protection to tissues by altering the CNS before/during a potentially damaging occurrence

-leading public health problem in US

-most common symptom that leads people to seek medical care

pain

manage the patient's pain and anxiety ____ performing a procedure

before

any persistent or irrational fear of something specific such as an object, activity, or situation that results on avoidance or desire to avoid the feared stimulus

phobia

______ million people have dental phobia

10 to 12

what is physiological pain?

acts as a signal, alerting us to potential tissue damage, and leads to a wide range of actions to prevent or limit further damage

when does physiological pain occur?

when sensory nerve endings, pain receptors, come into contact with a painful stimulus

good communication skills include:

warmth, empathy, and respect

-best expressed through eye contact

-a variety of scales are available to measure the levels of pain to allow clinicians to act appropriately and alleviate discomfort

-common scale rates pain in equal segments

-0 no pain

-10 unbearable

accessing and measuring pain

noninvasice, nonpharmacologic approach to sedation:

-words and actions used to facilitate a trusting relationship

-hypnosis

-acupuncture

-systematic desensitization, relax therapy

-distraction mechanisms

-TENS

invasive, pharmacologic approach to sedation (conscious patient):

-local anesthesia

-oral pharm agents

-intramuscular administration of pharm agents

-inhalation of medication

-IV administration of drug into circulatory system

invasive, pharmacologic approach to sedation (unconscious patient):

-general anesthesia

analgesic properties (pain control):

-raises the pt's pain threshold when given before intraoral injections

-used when other drugs are contraindicated (allergy)

-has the ability to manage both pain and fear

anxiolytic properties (sedative effects):

-assist patients in handling their fear of anxiety by producing sedation or a sense of well being

-pts become calm, relaxed, and able to tolerate the situation better

amnestic properties:

-pts often can't recall their pain or anxiety or its duration

-passage of time tends to become unclear or compressed

onsent of action:

-rapid: begins in less than 30 seconds, with peak usually occuring in less than 5 minutes

titration:

-process of administering a drug incrementally to a specific level or endpoint

-safety feature - minimizes unintentional overdose

desirable characteristics of nitrous oxide/oxygen:

-length and depth depend on the procedure

-rapidly eliminated from the body after use

-complete elimination times vary among individuals, physical and cognitive recovery is facilitated with 100% oxygen from a minimum of 5 mins

-a escort is not likely

-acceptance is well documented

combining nitrous oxide sedation with other methods:

-nitrous oxide is enhances with the spoken word

-distraction techniques

-audioanalgesia

-oral medication

-n20 and local anesthesia