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KMID : 0358920100370020213
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Journal of the Korean Academy of Pedodontics
2010 Volume.37 No. 2 p.213 ~ p.217
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CONVERTING FROM ORAL SEDATION TO INTRAVENOUS SEDATION USING TOPICAL ANESTHETICS ON SKIN AFTER ORAL SEDATION FAILURE
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Lee Eun-Hui
Kim Seung-Oh
Kim Jong-Soo
Yoo Seung-Hoon
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Abstract
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The use of chloral hydrate and hydroxyzine for oral sedation is most effective in children aged less than 36 months and weighing less than 15 kg. Children who do not belong to this category may show frequent movements due to shallow sedation level, and it can lead to sedation failures. One of the solutions to such sedation failure is conversion to deeper sedation. But, it is not so much of an option, since inhalation anesthetics and devices are required. In this case, conversion from oral sedation to intravenous sedation was successfully achieved without causing injection pain while searching for an intravenous route, by using EMLA cream (Eutectic Mixture of Local Anesthesia). A patient aged 46 months and weighing 15 kg visited the Pediatric Department of Dankook University Dental Hospital. Treatment under TSD(Tell Show Do) was offered, but due to the parent’s request, oral sedative measures were taken. Considering prompt converting from oral sedation to iv sedation in case the oral sedation fails, EMLA cream was apllied preemptively. Adequate sedation level could not be achieved after 90 minutes of oral administration, therefore, under the parent’s consent, intravenous route was prepared after conscious sedation by . During treatment, , and heart rate was monitored every 5 minutes. The patient showed stable vital signs and did not show any movements. The whole procedure took two and a half hours in total, and the treatment was completed without any adverse effects.
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KEYWORD
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EMLA cream, I. V route, I. V sedation
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