Dental treatment Sevoran in Alexandrov

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In modern dentistry, anti-stress treatment methods have been successfully used for a long time, which is especially important for children. In particular, Sevoran anesthesia allows children to avoid anxiety and pain and treat their teeth with comfort. After waking up, the child will not experience unpleasant sensations, he will not be disturbed by unpleasant memories. The absence of psychological trauma will save the child from dental phobia and will lead to the fact that in the future he will consult a doctor as soon as he feels some kind of problem with his teeth, and will not wait until the last minute, when the tooth most likely cannot be saved.

Interaction with other drugs

This harmless drug for mask anesthesia is excellent for adults and children; when using it, patients do not have to endure injections or lie under a drip. However, this type of anesthesia has a number of limitations and side effects.

Since even light anesthesia affects the speed of the reaction, after using Sevoran you should not immediately sit behind the wheel and do work that requires increased concentration.
Rare cases of side effects have been recorded in the form of a transient increase in blood glucose levels, pressure surges, tachycardia, headaches and muscle pain - they occur with existing concomitant diseases.
Within one to two days after using the drug, minor mood swings may be observed that go away on their own.

Sevoran anesthesia for children in dentistry

When treating children's teeth, Sevoran anesthesia has actually become the standard. Its use provides invaluable benefits.

Complete security. Sevoran is approved for use in children over one year of age. This drug has been well tested, tested, and has been used for quite some time. It does not cause severe side effects, does not place a large burden on the body, and no toxic metabolites are formed when administered. It only works as long as it is supplied through a special mask; as soon as the doctor turns off the supply, the effect stops, and after a few minutes the patient wakes up, except in those cases when the medicated sleep turns into normal and the child no longer sleeps under the influence of the drug, but on its own.

Perfect efficiency. Under the influence of the drug, the child does not experience any discomfort, pain, anxiety - he sleeps soundly, and the doctor carries out treatment at this time. Sevoran has not only a sedative and hypnotic effect, but also an analgesic effect, so it is used even in cases where local anesthesia cannot be used (for example, due to allergies) or may be insufficient (for extensive dental procedures).

Ease of administration. Sevoran is an inhalation drug that is administered through a breathing mask. In this case, no injections or intravenous injections are necessary.

Hypoallergenic. There is no allergy to this drug. It is also used in cases where the patient has allergic reactions to other anesthetics.

The Dental Master clinic has the necessary licenses for anesthesiology and resuscitation, allowing you to perform treatment under anesthesia. We also have all the necessary modern equipment and highly qualified doctors. During treatment, the child is under constant supervision of an anesthesiologist, who, using special equipment, monitors the baby’s condition and will take appropriate measures if any changes occur.

Side effects

Most of the side effects that occur when inhaling Sevoran are mild or moderate and go away on their own. The following adverse reactions have been reported in clinical studies and post-marketing surveillance:

digestive system: very often – vomiting and nausea; often - increased salivation; frequency unknown - jaundice, liver failure, pancreatitis, hepatitis, liver necrosis;
respiratory system: very often – cough; often – laryngospasm, breath holding, breathing disorders, airway obstruction; uncommon – bronchospasm, apnea, hypoxia; frequency unknown - wheezing, shortness of breath, respiratory depression;
cardiovascular system: very often – decreased blood pressure, bradycardia; often – increased blood pressure, tachycardia; uncommon – complete atrioventricular block, atrial arrhythmia, syncope, ventricular and supraventricular extrasystoles, arrhythmia, atrial fibrillation, second degree atrioventricular block, bigeminy, bleeding, ST segment reduction, T wave inversion; frequency unknown - ventricular fibrillation, cardiac arrest, prolongation of the QT interval;
nervous system and psyche: very often – agitation; often – headache, dizziness, drowsiness; infrequently – confusion; frequency unknown - increased intracranial pressure, dystonia, convulsions;
musculoskeletal system: frequency unknown – muscle rigidity;
skin and subcutaneous tissues: frequency unknown - urticaria, contact dermatitis, rash, itching, facial swelling;
metabolism and nutrition: frequency unknown - hypercreatininemia, hyperkalemia;
urinary system: frequency unknown – tubular interstitial nephritis;
immune system: frequency unknown - anaphylactic and pseudoanaphylactic reactions, hypersensitivity reactions;
laboratory parameters: often - changes in the number of leukocytes, changes in glucose concentration, transient increase in fluoride concentration, transient disturbances in liver function tests; frequency unknown - increased plasma concentration of phosphorus;
other reactions: often – fever, chills, hypothermia; frequency unknown - chest discomfort, malignant hyperthermia.

In what cases is mask anesthesia with Sevoran used in children?

There are specific indications for the use of Sevoran for children in dentistry:

age 1-3 years – at this time it is difficult for a child to sit still in the dentist’s chair, which makes treatment difficult, and in some cases makes it impossible,
panic fear of the dentist, which cannot be eliminated in other ways,
allergy to local anesthetics, which will not allow for quality treatment,
various diseases, as well as developmental features that do not allow the doctor to establish contact with the child,
a large amount of dental intervention requiring prolonged treatment or serious impact (for example, tooth extraction).

In each specific case, the pediatric dentist of our clinic discusses in detail the prospects for treating the child under anesthesia with the parents, talks about all the nuances, explains the advantages and features of the technique, and invites an anesthesiologist for consultation.

Dosage

Anesthesia with Sevoran is selected individually for each patient.

Thus, during surgery, anesthesia is administered using a vaporizer. As a rule, anesthesiologists use special devices calibrated specifically for this drug.

The dosage is selected individually in each specific case. Titration continues until the desired effect occurs, while taking into account the patient’s clinic, his medical history, concomitant diseases and age. After the end of the Sevoran administration, the patient is administered a drug from the group of barbiturates or another type of anesthetic, which is designed for intravenous administration in order to obtain deep anesthesia. Typically, oxygen and nitric oxide or Sevoran together with oxygen are used for these purposes.

A small amount of Sevoran anesthesia before surgery allows you to achieve the stage of deep sleep in a couple of minutes, and this applies to both adult patients and children. With this anesthesia, a quick recovery from the anesthesia state without the use of any additional drugs is very characteristic: patients rarely complain of long-term depression after this, thinking functions are restored very quickly, people do not feel any discomfort at the site of the operation and injection.

In addition, anesthesia with Sevoran provides the necessary level of anesthesia. The concentration is selected in the range from 0.55 to 3%, the drug is administered together with nitric oxide.

In case of overdose, the patient may experience the following symptoms:

The activity of the central nervous system changes.
Hypotension.
Vascular collapse.
Cramps.
Stopping breathing.

If such symptoms appear, then you urgently need to stop administering the drug, install a clean breathing tube and begin artificial ventilation of the lungs with oxygen, monitor the work of the heart, if you need to administer drugs to maintain it.

The medication is used by inhalation.

The administration of Sevoflurane is stopped, measures are taken to maintain adequate functioning of the cardiovascular system, controlled or assisted ventilation of the lungs is started, and the patency of the respiratory system is maintained.

Anesthesia Sevoran is an anesthetic agent that is often used in modern medicine. This medicine is intended for anesthesia performed using the inhalation technique. As an anesthetic substance, Sevoran is used for short operations or for dental treatment of young children.

Treatment of baby teeth with sevoran

Parents often ask themselves the question: is it worth treating a child’s baby teeth if they are already falling out? There is some reason for this - indeed, to waste energy, force the child to undergo not very pleasant treatment procedures only so that the cured tooth falls out after a short time and a permanent one grows in its place. But the thing is that replacing baby teeth with permanent ones is a long process. On average it lasts approximately 10 years. But it is not at all uncommon for individual baby teeth to survive until the age of 20 or even 30 years. Imagine that this particular baby tooth will fall out in a child only after 10 years. Will he suffer all these years? And then, even if the baby tooth does not hurt much, but simply collapses, what will the child chew on until his permanent tooth erupts?

Simply put, it makes no sense to treat only those baby teeth that are already loose and close to falling out. But those that are still holding up well can and should be treated.

Treatment of baby teeth with Sevoran will be completely painless and comfortable. The method is no different from the treatment of permanent teeth.

Reviews

The first visit to the dentist can be a daunting experience for children and their parents. In each of the clinics of the Natadent network, we have created a truly warm and comfortable environment. We welcome every feedback - you help us become better.

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Not only adult patients speak very well of the drug, but also children, who say that they breathed in the fragrant air and fell asleep, and then opened their eyes - and they were already lying on the bed, and nothing hurt them. In fact, this is exactly how Sevoran works. Reviews from parents also confirm that their children tolerate anesthesia very easily, and it does not cause any side effects or allergies. It is thanks to him that many children began to visit the dentist even more often, and all because all procedures are carried out without pain.

Adult patients also speak quite positively about their condition after such anesthesia. The most important thing is that it is carried out by a competent specialist, then everything will be fine.

Any parent strives to protect their child from unnecessary pain, so dental treatment under general anesthesia is becoming an increasingly popular service. At the same time, there are not many places in the capital where children can have their teeth treated under Sevoran.

When contacting the Natadent clinic, you can be sure that your child will be treated by a qualified specialist who will do everything to ensure that your child does not experience unnecessary pain. You can verify this by reading the reviews below, which are regularly written by our little patients and their parents.

Anesthesiologists actively discuss the drug on a thematic forum. The most frequently discussed issues are the use of Sevoran in children and its consequences. Many experts agree on one thing - the drug is easier to tolerate than its analogues, causes fewer negative reactions, and after anesthesia there are no pronounced consequences.

When used in pediatrics, the advantage of Sevoran is that the mask does not have a specific odor, which can cause negative reactions in children and complicate the administration of anesthesia. Experts speak positively about this anesthesia, considering it one of the best in its group.

Method of dental treatment under anesthesia Sevoran for children

Sevoran is administered in two stages - the initial administration through an oral-nasal mask, and then, when the child has fallen asleep (literally after 2-3 breaths), a laryngeal mask is placed, through which the patient breathes during treatment. Local anesthesia can only be used in cases where it is necessary to extend the analgesic effect for a period after treatment and after the end of anesthesia (for example, when several teeth are removed). Inhalation anesthesia with Sevoran is effective only during its introduction into the body. Once the feed stops, most babies are usually awake within 20 minutes.

Children cope with recovery from anesthesia differently, because they themselves are all different, with their own characteristics of the body. Sometimes there may be a short-term lack of coordination of movements, in some cases - a state of excitement. Some people experience dizziness and nausea. Some children may be fussy after waking up - this may be caused by unusual sensations.

Our clinic has a separate room where the child can wake up on his own, naturally in the presence of his parents. Oxygen was supplied to this room to speed up the removal of the remnants of anesthesia from the child’s body, and an anesthesiologist monitored the awakening of the little patient.

special instructions

The medication can only be used by medical specialists who have the skills to administer general anesthesia in specialized departments equipped with devices for mechanical ventilation, restoring the patency of the respiratory system, resuscitation, and oxygen therapy. The concentration of the active substance that comes from the evaporator must be precisely known. For this purpose, calibration evaporators are used specifically for the drug Sevoran. All inhalational anesthetics differ in their physical properties.

The dose of Sevoflurane is selected on an individual basis, assessing the patient’s overall response. An increase in concentration may be accompanied by respiratory depression and increased severity of arterial hypotension.

Cases of QT prolongation on the ECG have been reported (less often there was a connection with tachycardia of the “pirouette” type, extremely rarely with death)

The medication is used with caution in patients with these complications. Ventricular arrhythmias have been reported in pediatric patients with Pompe disease.

Use with caution in persons suffering from mitochondrial diseases. As the concentration of the active substance increases, a dose-dependent drop in blood pressure is observed, which may be associated with the depth of general anesthesia

In such cases, it is recommended to reduce the concentration of the anesthetic administered.

To prevent ischemic changes in the myocardium in people suffering from coronary artery disease, it is necessary to maintain stable hemodynamics. Before transfer to a specialized department after recovery from anesthesia, additional observation of the patient by specialists of the appropriate profile is mandatory.

In pediatric practice, cases of increased potassium concentration in the blood have been reported, which provoked arrhythmias and could cause death. At risk are young patients with Duchenne muscular dystrophy and various neurological diseases that occur latently or overtly. There was a more frequent pattern with the use of Suxamethonium (succinylcholine), and patients had an increase in creatine phosphokinase, myoglobinuria and changes in the composition of urine.

Differential diagnosis of malignant hyperthermia is based on the absence of symptoms associated with muscle metabolism, as well as muscle rigidity. When diagnosing neuromuscular pathology, antiarrhythmic measures and procedures to relieve hyperkalemia are carried out. Patients recovering from general anesthesia should be assessed by specialists before transport.

Consequences of using anesthesia with Sevoran

For some time after general anesthesia, patients may experience difficulties performing complex work or driving vehicles, which is reversible.

Contraindications to the procedure

In order for dental treatment under Sevoran to be completely safe, it is important to take into account the patient’s health characteristics and not use this type of anesthesia if there are contraindications, which include:

individual intolerance to this drug (very rare, but does occur),
hypertension and increased intracranial pressure,
malignant hyperthermia.

In addition to absolute contraindications to Sevoran anesthesia for children, there are factors in the presence of which this drug should be prescribed with caution, taking measures to relieve possible complications. These factors include:

cardiovascular diseases (CHD, etc.),
chronic liver and kidney diseases,
neuromuscular disorders,
tendency to seizures,
simultaneous use of calcium channel blockers (nifedipine, cordipine, verapamil), alpha and beta sympathomimetics (isoprenaline, epinephrine, norepinephrine).

Side effects and contraindications

The consequences of using sevoran do not always appear and not for everyone:

Drowsiness, agitation, dizziness, short-term convulsions, sudden changes in mood within several days after completion of anesthesia;
Respiratory depression, various respiratory disorders, increased cough;
Depression of cardiac activity, increase or decrease in blood pressure, tachycardia, bradycardia;
Vomiting, nausea, excessive salivation;
Itching, urticaria, rash, anaphylactic reactions;
Fever, chills.

If the patient has a predisposition, then powerful anesthetics for inhalation anesthesia (including sevorane) often provoke the appearance of a state of hypermetabolism in skeletal muscles, which causes an increase in their oxygen requirements and the development of a clinical syndrome.

There are also certain contraindications to such inhalation anesthesia with sevoflurane gas:

High sensitivity to sevoflurane and any other halogenated anesthetics;
The presence or suspicion of a genetic predisposition to the occurrence of malignant hyperthermia;
Lactation period.

In addition, experts do not prohibit, but recommend with extreme caution the use of sevoflurane for anesthesia in cases of renal failure, intracranial hypertension, coronary heart disease and neuromuscular diseases. Children are allowed to use sevoflurane in reduced dosages, taking into account the age and weight of the child, as well as his general condition and the presence of serious illnesses

In cases of sevoflurane overdose, it is necessary to immediately stop the administration of the drug for anesthesia, begin active airway support using controlled or assisted ventilation with oxygen administration

In this case, special attention should be paid to supporting the normal functioning of the cardiovascular system.

Are there any consequences after using Sevoran in children during dental treatment?

If safety rules are followed, the effects of Sevoran in children are almost always mild (when compared with other types of anesthesia) and short-lived. Mainly:

dizziness, drowsiness, lethargy - goes away within half an hour,
nausea and vomiting (in 2-3 patients out of 100),
increased excitability, moodiness (in about 15 small patients out of 100), mostly due to long abstinence from food and unusual sensations,
increased temperature (as a rule, this is a consequence of serious dental procedures - tooth extraction, trauma to the mucous membrane),
unpleasant or painful sensations - again due to dental procedures.

All these possible effects do not pose a threat to the baby’s health, so they should not be considered decisive when planning treatment. Of course, if there is an opportunity to treat teeth without anesthesia, you should take advantage of it. In situations where anesthesia remains the only remedy, it should not be neglected. Dental treatment for children under Sevoran anesthesia is completely harmless and safe, which is confirmed by numerous medical studies, as well as the large-scale use of this type of anesthesia in dental clinics in many countries in Europe, America, Israel, and Russia.

As we have already said, Sevoran does not have a serious effect on the central nervous system, it dissolves poorly in the blood, does not irritate the respiratory tract, does not leave toxic metabolites (decomposition products), and has virtually no effect on blood counts and metabolism. Within a few minutes after stopping the supply, Sevoran is eliminated from the body through the lungs, and small residual amounts are excreted in the urine. All residual and side effects after cessation of anesthesia in a child quickly disappear without leaving any traces.

Release form and composition

Sevoran is available in the form of a liquid for inhalation: easily mobile, colorless and transparent (100 and 250 ml each in a dark-colored PE naphthalate bottle, closed with a special closure system (Quik-Fil) made of polyacetal/PE with a protective film cap placed on top with holographic company logos on a metallized tape; 1 bottle in a cardboard box; 6 bottles in a corrugated cardboard box with a cardboard divider).

1 bottle contains the active substance - sevoflurane (fluorinated derivative of methyl isopropyl ether) - 100 or 250 ml.

Is there an alternative to using anesthesia?

Yes, of course there is! At the Dental Master clinic, we use not only mask anesthesia Sevoran for children (or another drug for intravenous administration - propofol), but also mild sedation with nitrous oxide. The oxygen-nitrogen mixture is supplied through a nasal breathing mask. This option is much easier than anesthesia - the child does not fall asleep, but remains conscious, hears everything, understands and can respond to the doctor’s requests, but is in a calmer and more relaxed state.

This anti-stress treatment option requires local anesthesia because nitrous oxide is calming but does not have an analgesic effect. Our pediatric dentist Tatyana Vladimirovna Ermakova will do everything to calm the child, set him up in a positive mood and treat him using only nitrous oxide sedation and local anesthesia, but in some situations, the only way to properly treat a child’s teeth is anesthesia.

How is anesthesia administered at the Shifa Clinic?

At the Shifa clinic, anesthesia care is provided by a team consisting of an anesthesiologist-resuscitator and a nurse anesthetist. Combined anesthesia is used: combined inhalation anesthesia with Sevoran (ABBOT Laboratories, USA) and local anesthesia in the intervention area with articaine drugs without vasoconstrictor components. Local anesthesia is performed to reduce the dose of inhalational anesthetic. Throughout the treatment, clinic specialists carry out monitoring, including:

pulse oximetry (determining heart rate);
ECG (electrocardiography);
blood pressure measurement;
capnography (determining the concentration of carbon dioxide during the patient’s respiratory cycle in inhaled and exhaled gas; graphical display of measurement results);
body thermometry.

The obtained data is recorded and stored in the memory of anesthesiological equipment for 2 months after anesthesia.

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