Impact of Inhalation Sedation on Cardiovascular Haemodynamics in Hypertensive Patients Requiring Dental Treatment: A Clinical Observational Study
TL;DR
Inhalation sedation with nitrous oxide and oxygen was associated with reductions in heart rate and blood pressure in hypertensive patients undergoing dental treatment, while maintaining stable oxygen saturation, and was also associated with reduced dental anxiety and facilitation of dental procedures.
Abstract
Background Several research studies reported the anxiolytic and analgesic properties of nitrous oxide sedation, as well as its effectiveness in facilitating dental procedures for anxious populations, specifically, dental patients with high blood pressure. Objective This clinical observational study aims to assess the impact of inhalation sedation using nitrous oxide mixed with oxygen on cardiovascular haemodynamics in hypertensive patients requiring dental treatment. Methods and Materials Adult dental patients with hypertension and dental anxiety who attended the dental clinic with acute dental pain were included in the study. Non-invasive blood pressure (NIBP/mmHg), heart rate (beats per min (bpm)), and oxygen saturation (SPO2%) were measured before, during, and after inhalation sedation. Participants’ dental anxiety and need for conscious sedation were measured using the Modified Dental Anxiety Scale and the Indicator of Sedation Need, respectively. Dental procedure characteristics and sedation details were also collected, such as procedure type and duration, number of visits, and nitrous oxide concentration. Results Significant reductions in heart rate and blood pressure were observed during and after the procedure compared with baseline. Mean heart rate decreased from pre-sedation to intraprocedural and post-procedural phases, while blood pressure shifted from pre-hypertensive or hypertensive levels to normal in most participants during and after sedation. Respiratory rate remained stable, and oxygen saturation was maintained at optimal levels throughout all phases. Conclusion Inhalation sedation with nitrous oxide and oxygen was associated with reductions in heart rate and blood pressure in hypertensive patients undergoing dental treatment, while maintaining stable oxygen saturation. It was also associated with reduced dental anxiety and facilitation of dental procedures. These findings suggest a potentially beneficial role for inhalation sedation in this population; however, causal inferences are limited by the observational study design.