The use of inhalation sedation and local anaesthesia as an alternative to general anaesthesia for dental extractions in children

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