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Anesthesia · single question

A 5-year-old with Down syndrome has a gastric tube and severely diminished cooperation. What is the most appropriate sedation for dental cleaning?

  1. Nitrous oxide in office
  2. Hospital setting with general anesthesia
  3. Outpatient with local anesthesia only
  4. Outpatient with oral sedation
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Correct answer: B. Hospital setting with general anesthesia

  • A. ❌ Nitrous oxide requires cooperation and nasal breathing — not appropriate for this patient.
  • B. ✅ Correct. Down syndrome + gastric tube (medical complexity, aspiration risk) + non-cooperation requires GENERAL ANESTHESIA in a hospital setting with full monitoring, airway management, and emergency support available.
  • C. ❌ Local anesthesia alone will not achieve adequate cooperation for treatment.
  • D. ❌ Outpatient oral sedation is not appropriate for a medically complex patient with high aspiration risk.

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