MEOPA (equimolar mixture of oxygen and nitrous oxide) is a gas intended to facilitate dental care. This therapeutic option can be considered in excessively anxious patients, in children or in disabled patients.
This practice brings real added value to the care provided since MEOPA allows the patient to relax without falling asleep and to maintain consciousness
throughout the care: this is called "conscious sedation".
For the correct use of nitrous oxide in the context of light sedation, it is essential to know the advantages and disadvantages, as well as the contraindications. In addition, the effect of repeated exposure of nursing staff to nitrous oxide should be known and taken into account.
"Light sedation", sometimes also called "minimal sedation", is a technique consisting in reducing the level of anxiety and stress of the patient by administering a drug, without decreasing his level of consciousness, the verbal communication remaining possible and the respiratory and cardiovascular functions remaining intact. Mild sedation can be obtained using a mixture of nitrous oxide (at most 50%) and oxygen, and can, in dentistry, avoid as much as possible deep sedation or general anesthesia.
It should be emphasized that although the application of light sedation with nitrous oxide has some analgesic effect, optimal local anesthesia remains essential.
Oxygen and nitrous oxide, as well as their mixtures (50% nitrous oxide and 50% oxygen), are authorized as drugs and can be prescribed by dentists and doctors if they do not contain no more than 50% nitrous oxide.
The dentist performing the procedure should be assisted by a person who administers nitrous oxide and monitors the patient.
Continuous and rigorous clinical monitoring of the patient is essential, both during inhalation of the nitrous oxide mixture and afterwards, until the patient is fully awake. Here it is necessary to observe the state of general well-being, the state of consciousness, breathing (which should not be hindered) and blood circulation (color of the skin and mucous membranes, observations supplemented by a determination of oxygen saturation by pulse oximetry).
It is recommended to administer pure oxygen for a few minutes after stopping the inhalation of nitrous oxide and to continue to observe the patient for at least 15 minutes until complete recovery of consciousness, balance and motor functions.
The technique is simple, safe and effective, the product does not cause postoperative heaviness and its elimination is rapid, which allows immediate and safe home return.
In pediatric dentistry, this practice constitutes an additional step before the final resort to general anesthesia.
In the more or less long term, some children or teenagers then agree to be treated in a "classic" environment.
The therapeutic acts carried out in this context must always be extended by a personalized prevention program and regular monitoring.
Important note: Patients treated with MEOPA must have fasted for at least 2 hours prior to the intervention.