Aspectos farmacológicos no controle da ansiedade em odontopediatria: uma revisão de literatura

Abstract

Proper management is necessary in pediatric dentistry so that quality and safe care can be offered to the patient. When basic behavior management techniques fail to reproduce cooperation, some form of sedation may be the best approach. Minimal sedation is used in pediatric dentistry as a pharmacological behavioral control technique, which induces the patient to a state of depression of consciousness in order to increase cooperation during care. In this context, studies have highlighted the use of benzodiazepines or antihistamines as drugs that, in isolation or in combination with other drugs, present an efficient clinical result. This study aims to conduct a literature review about the use of these drugs as a therapeutic agent in controlling anxiety, both in isolated administration and in combination. A search was carried out in the PubMed, CAPES databases, in English, French and Portuguese, from June 2019 to January 2021. 72 articles were found, of which 49 were selected and read in full, as they are associated to the topic and because they are fully available in the database. Studies show that midazolam (benzodiazepine) works effectively to control anxiety, with effects of sedation and retrograde amnesia. With regard to Hixizine (Hydroxyzine Hydrochloride), it acts as a long-lasting antihistamine H1 antagonist, between 6 to 24 hours, acting as a central nervous system (anxiolytic) depressant. The use of hixizine in pediatric dentistry for conscious sedation generally occurred in association with another medication and as a pre-medication for nitrous oxide / oxygen inhalation. Therefore, the increase in clinical time, better patient behavior, as well as unreported adverse effects, show drug therapy as an excellent alternative for the management of pediatric pediatric patients.