Page 10 - WOM SUMMER 18-19

The hidden benefits of
Relative Analgesia
itrous Oxide sedation or relative analgesia
is the safest form of sedation available to
the Dentist. It’s effective for the majority of
patients and particularly useful in treating
Nchildren. I think every practice should be
able to offer Nitrous Oxide for the benefits to their
patients and themselves. That’s right, Nitrous Oxide
provides a lot of benefits to the Dentist; a less stressed
patient means a less stressed Dentist and in these
competitive times being able to make patients
more comfortable and less fearful at the dentist is a
significant advantage. Nitrous Oxide also provides
By Dr. Michael Walker, analgesia which is an often forgotten component
NSW BDS, FPFA of this technique. Patients often react to pressure
and movement even when there is effective local
anaesthesia, Nitrous Oxide analgesia provides an
effective relief from this.
The other great thing about Nitrous Oxide /Oxygen
sedation is that due to its safety it can be administered
to many and variously medically compromised
patients, because even at a maximum dose of
seventy percent Nitrous Oxide [N2O-70 %] you are
still providing thirty percent Oxygen [O2 -30%] and
that 30% oxygen is 50% higher than environmental air
which is 20% Oxygen.
No technique is fool proof. The medical status of the
patient must always be continuously assessed as well
as the patient’s suitability. This is where appropriate
training comes in, in a well taught education program,
taught by people that are educators and regularly
use nitrous oxide in a practical situation.
I have used Nitrous Oxide in my practice for over 30
years and it is one of the most valuable tools in my
armamentarium. I say this as a dentist who holds a
Dental Board of Australia endorsement in conscious
sedation, which allows me on any day of the week to
administer intravenous sedation using midazolam and
fentanyl. I employ registered nurses in my practice
and have my own General Anaesthetic facility. So, I
can and do provide many levels of service to patients,
but still Nitrous Oxide is an extremely valuable tool.
The reasons that Nitrous Oxide / Oxygen sedation
is so valuable is that it can be used any time at a
moment’s notice. The patient does not need to fast
(as with intravenous sedation) and there is no need
for an escort, because nitrous oxide does not really
chemically interact with the body, like Midazolam or
Valium. Once you turn the delivery of nitrous oxide off
at the mixer, the RA machine can give 100% oxygen
and the effects are completely reversed quickly and
8 WORD OF MOUTH SUMMER 18/19
the patient is ambulatory and safe to leave your you and patients can experience with the use of
practice and drive. Nitrous Oxide and in the hope that you will revisit or
explore the topic further. I commend Nitrous Oxide
Some patients take a little longer than others to to you as a valuable and safe tool to use in practice
recover from Nitrous Oxide sedation, but unlike and I encourage you to explore the opportunities it
sedative drugs like Midazolam or Valium it leaves provides.
the body quickly with no residual. If you use oral or
intravenous drugs the effects can hang around for
hours and so patients need an escort and someone
to drive them home. On that note, if you do use oral
sedation like Temazepam or Valium for example you Relative Analgesia Full Day Course
are responsible for the patient when they exit your
practice, this is not true for Nitrous Oxide. COURSE DATES
SYDNEY MELBOURNE SYDNEY
16th March 2019 27th July 2019 21st September 2019
VENUE: to be advised
FEE: $990.00 inc gst and includes catering
SUMMARY
This is a course that meets the standards of the International
Federation of Dental Anaesthesiology Societies. The first half of the
day will be lecture style with the afternoon being hands-on.
Nitrous Oxide is only as good as it is used and This course will enable participants to become proficient and
administered in your practice, and as I teach this, I confident in the administration of nitrous oxide in clinical practice.
know many people come to courses with no or only
undergraduate exposure. I am also a senior lecturer This course is a refresher for dentists wishing to update their theory
in the Conscious Sedation Diploma at the University and practical skills in the delivery of relative analgesia. Participants
of Sydney for people seeking an endorsed Dental will be given the opportunity to administer nitrous oxide – oxygen
Board qualification in intravenous sedation. I often sedation to each other, and to experience themselves them effects
ask new candidates ”playing devil’s advocate” of the gases in a safe environment.
if they use oral sedation in practice. If the answer LEARNING OUTCOMES
is yes, then I ask where did they obtain their • Learn the legal requirements to use RA
formal training from . I often get a blank look from • Why should you use RA instead of other oral sedation
candidates, as this would be one of the first questions • How to use RA correctly
posed to them if they had a problem with a patient. • Sedation within the dental practice
• Current fees and charges for RA procedures
Nitrous Oxide sedation is specifically excluded from
the Dental Board’s requirement that a Dentist must TOPICS
have a qualification (Diploma in Conscious Sedation) • Practical application of the use of relative analgesia on patients
if they administer sedation by any route. Any dentist • Usage of relative analgesia armamentarium
• Appropriate maintenance and sterilisation of equipment
can administer nitrous oxide [with training] to patients. • Indications and contra-indications of relative analgesia
This article was written to bring to light the benefits
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WORD OF MOUTH SUMMER 18/19 9