EAPD Guidelines on Sedation in Paediatric Dentistry A.-L. Hallonsten, B. Jensen, M. Raadal, J. Veerkamp, M.T. Hosey, S. Poulsen It should be emphasized that these guidelines are only dealing with conscious sedation, which implies that the patient has • Minimally depressed consciousness • Ability to maintain open airway • Protective reflexes maintained • Response to physical and verbal stimulation Introduction ................................................................................................................................................... 2 Sedation in Paediatric Dentistry .................................................................................................................... 2 Need for guidelines on sedation................................................................................................................ 2 Legislation ................................................................................................................................................ 2 Restraint .................................................................................................................................................... 2 Sedation and pain control ......................................................................................................................... 2 Objectives for sedation in paediatric dentistry.......................................................................................... 2 Definitions ................................................................................................................................................ 3 Patient selection and assessment ................................................................................................................... 3 Indications and contraindications ............................................................................................................. 3 Patient monitoring .................................................................................................................................... 4 Patient information ........................................................................................................................................ 4 Written and oral information and consent ................................................................................................ 4 Fasting....................................................................................................................................................... 5 Discharge .................................................................................................................................................. 5 Documentation and records........................................................................................................................... 5 Safety for the staff ......................................................................................................................................... 5 Education and Training ................................................................................................................................. 6 Drugs ............................................................................................................................................................. 6 Nitrous oxide ............................................................................................................................................ 6 Benzodiazepines (BZD) ............................................................................................................................ 6 Other agents with sedative properties ....................................................................................................... 7 Nitrous oxide/oxygen inhalation sedation ..................................................................................................... 7 Indications................................................................................................................................................. 7 Contraindications ...................................................................................................................................... 7 Side effects................................................................................................................................................ 8 Dosage ...................................................................................................................................................... 8 Safety for the staff .................................................................................................................................... 8 Midazolam sedation ...................................................................................................................................... 8 Indications................................................................................................................................................. 8 Contraindications ...................................................................................................................................... 8 Side effects................................................................................................................................................ 8 Clinical considerations.............................................................................................................................. 8 Routes ....................................................................................................................................................... 8 Doses......................................................................................................................................................... 9 Diazepam sedation ........................................................................................................................................ 9 Routes ....................................................................................................................................................... 9 Doses......................................................................................................................................................... 9 Appendix I................................................................................................................................................... 10 Appendix II ................................................................................................................................................. 11