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Uma visão geral sobre sedação consciente, fármacos, segurança, doses e limitações : mapa de classificação de evidências
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Abstract(s)
Objetivo: Comparar guidelines internacionais de sedação consciente em Odontopediatria, acerca da divergência e convergência de informações entre estas, para se poder inferir sobre as práticas clínicas atuais.
Materiais e Métodos: Foi realizada uma pesquisa metodológicas nas seguintes bases de dados: PubMed (via Medline), Scopus, Cochrane Database of Systematic Reviews, Scielo (Scientific Electronic Library Online), EMBASE (The Excerpta Medica Database), LILACS (Latin-American scientific literature in health sciences), TRIP (Turning Research Into Practise), World of Science e Open Grey, até abril de 2023. Foram incluídas as guidelines produzidas por entidades reconhecidas e que abordassem sedação consciente em Odontopediatria e não foram feitas restrições relativamente ao ano de publicação ou idioma. A comparação das guidelines foi efetuada através de uma tabela com tópicos transversais entre elas.
Resultados: Foram incluídas 12 guidelines internacionais elaboradas por entidades reconhecidas dos diferentes continentes. Relativamente às informações analisadas, existe convergência em 50 % dos tópicos, tais como, objetivos da sedação, definição dos diversos níveis de sedação, indicações, educação e treino da equipa, avaliação e preparação do paciente, documentos e registos necessários, necessidade de jejum e
monitorização. As divergências são predominantes em relação aos fármacos, dosagens e vias de administração, não existindo concordância no que diz respeito às técnicas e sedação mais apropriada.
Conclusão: Considerando as informações derivadas da análise comparativa do conteúdo das guidelines, não se pode inferir sobre qual a melhor devido às divergências entre elas.
As práticas clínicas devem ser ajustadas às guidelines locais pois não existe consenso universal.
Objective: Compare international guidelines on conscious sedation in Pediatric Dentistry, regarding the divergence and convergence of information between them, in order to infer about current clinical practices. Materials and Methods: A methodological research was conducted in the followingdatabases: PubMed (via Medline), Scopus, Cochrane Database of Systematic Reviews, Scielo (Scientific Electronic Library Online), EMBASE (The Excerpta Medica Database), LILACS (Latin-American scientific literature in health sciences), TRIP (Turning Research Into Practice), World of Science, and Open Grey, up to April 2023. Guidelines produced by recognized entities that addressed conscious sedation in Pediatric Dentistry were included, without restrictions on publication year or language. The comparison of guidelines was performed using a table with cross-cutting topics among them. Results: Twelve international guidelines developed by recognized entities from different continents were included. Regarding the analyzed information, there is convergence in 50% of the topics, such as sedation objectives, definition of different sedation levels, indications, team education and training, patient evaluation and preparation, necessary documents and records, fasting requirements, and monitoring. Divergences are predominant regarding medications, dosages, and routes of administration, with no agreement regarding the most appropriate sedation techniques. Conclusion: Considering the information derived from the comparative analysis of the guidelines' content, it is not possible to infer which one is the best due to the divergences between them. Clinical practices should be adjusted to local guidelines as there is no universal consensus.
Objective: Compare international guidelines on conscious sedation in Pediatric Dentistry, regarding the divergence and convergence of information between them, in order to infer about current clinical practices. Materials and Methods: A methodological research was conducted in the followingdatabases: PubMed (via Medline), Scopus, Cochrane Database of Systematic Reviews, Scielo (Scientific Electronic Library Online), EMBASE (The Excerpta Medica Database), LILACS (Latin-American scientific literature in health sciences), TRIP (Turning Research Into Practice), World of Science, and Open Grey, up to April 2023. Guidelines produced by recognized entities that addressed conscious sedation in Pediatric Dentistry were included, without restrictions on publication year or language. The comparison of guidelines was performed using a table with cross-cutting topics among them. Results: Twelve international guidelines developed by recognized entities from different continents were included. Regarding the analyzed information, there is convergence in 50% of the topics, such as sedation objectives, definition of different sedation levels, indications, team education and training, patient evaluation and preparation, necessary documents and records, fasting requirements, and monitoring. Divergences are predominant regarding medications, dosages, and routes of administration, with no agreement regarding the most appropriate sedation techniques. Conclusion: Considering the information derived from the comparative analysis of the guidelines' content, it is not possible to infer which one is the best due to the divergences between them. Clinical practices should be adjusted to local guidelines as there is no universal consensus.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Conscious sedation Pediatric Pediatric dentistry Guidelines