Conscious Intravenous Sedation in Dentistry

Southerland, Janet H.; Brown, Lawrence R.

doi:10.1016/j.cden.2015.11.009

Cited by 21 publications

(21 citation statements)

References 137 publications

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“…These medications are generally reserved for those with advanced formal training in deep sedation and GA because of their narrow therapeutic margin such that an unintended deep level of sedation is easily achieved. [7][8][9] The most significant and concerning finding in the 2016 survey indicated that dentists in the State of Illinois were not 100% compliant with established state rules and regulations. The 2016 survey final question asked providers if there were any deaths, disabilities, or injuries during or after treatment under sedation or GA over the last 10 years.…”

Section: Discussionmentioning

confidence: 99%

Illinois Dental Anesthesia and Sedation Survey for 2016

Flick

Lloyd

2019

Anesthesia Progress

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A statewide decennial survey was sent to practicing dentists holding sedation or general anesthesia permits to identify office sedation/general anesthesia trends and practices over the last 10 years. This survey constitutes the third such survey, spanning a total of 20 years. Of the 234 respondents in the 2016 survey, 34% held an Illinois moderate sedation permit and 64% held a general anesthesia permit. Oral and maxillofacial surgeons represented the majority of respondents (143/234; 61%). The remainder of responses were from general dentists (39; 17%) pediatric dentists (32; 14%), periodontists (16; 7%), dentist anesthesiologists (3; 1.3%) and 1 periodontist/dentist anesthesiologist. Surveys over the 20 years revealed the following significant trends: an increase in practitioners current in advanced cardiac life support certification, an increase in the number of non-oral maxillofacial surgeons with a sedation permit, an increase in providers of moderate sedation, and an increase in offices equipped with end-tidal CO2 and electrocardiogram monitoring. However, a number of providers were identified as not compliant with certain state mandates. For example, many respondents failed to meet minimum office team staffing requirements during sedation, hold semiannual office emergency drills, and establish written emergency management protocols.

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Section: Discussionmentioning

confidence: 99%

Illinois Dental Anesthesia and Sedation Survey for 2016

Flick

Lloyd

2019

Anesthesia Progress

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“…Some dental practices use moderate sedation to manage patient pain and anxiety during dental procedures. 46 Early identification of adverse respiratory events and hypoxemia that may occur during sedation enables rapid interventions and prevents hypoxic brain damage, cardiac arrest, or death. 6 Adding capnography to standard monitoring of adult patients during moderate sedation improves sensitivity to detect adverse respiratory events and reduces the risk of developing hypoxemia where supplemental oxygen is routine.…”

Section: Discussionmentioning

confidence: 99%

“…Patients may attain varying levels of sedation during a single procedure, and propofol commonly induces deep sedation. 46 Because investigators did not assess patients' levels of consciousness in all studies, some of the studies likely included patients whose sedation levels were deeper than that typically used in dentistry. Nonetheless, these results can be interpreted to suggest that inclusion of capnography when monitoring adult patients during moderate sedation can improve early identification of respiratory events.…”

Section: Strengths and Limitations Of This Reviewmentioning

confidence: 99%

Benefits and harms of capnography during procedures involving moderate sedation

Parker¹,

Estrich²,

Abt³

et al. 2018

The Journal of the American Dental Association

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“…No anesthetic complications were observed in our case series. As many patients with chronic TMJ dislocation are elderly and have other health issues, performing eminectomy under local anesthesia plays a very important role for these patients [15]. Kitamura et al [4] reported the advantages of eminectomy compared to other open surgeries in terms of recurrence rates.…”

Section: Discussionmentioning

confidence: 99%

Eminectomy for Habitual Luxation of the Temporomandibular Joint with Sedation and Local Anesthesia: A Case Series

Iwanaga

Nakamura

Kusukawa

et al. 2016

Case Reports in Dentistry

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Eminectomy which is one of the popular and most effective treatments for habitual temporomandibular joint luxation was first described by Myrhaug in 1951. There are few reports which described eminectomy being performed under local anesthesia and conscious sedation. We present a case series of habitual luxation of the TMJ treated by eminectomy performed under local anesthesia and conscious sedation and general anesthesia. Five patients were examined and found to have recurrent luxation of the TMJ. The age of patients ranged from 18 to 93 years. Bilateral eminectomy of the TMJ was performed for two patients, and unilateral eminectomy was performed for three patients. Two were examined under intravenous propofol sedation and local anesthesia, while three patients were examined under general anesthesia. One patient died from ileus one month after surgery. The follow-up period except for the case that died from ileus ranged from 12 to 33 months. No recurrent dislocation of the TMJ has been identified. Based on our experience and two other series in the literature, eminectomy with sedation and local anesthesia can be considered and might be a good option in elderly patients.

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Conscious Intravenous Sedation in Dentistry

Cited by 21 publications

References 137 publications

Illinois Dental Anesthesia and Sedation Survey for 2016

Illinois Dental Anesthesia and Sedation Survey for 2016

Benefits and harms of capnography during procedures involving moderate sedation

Eminectomy for Habitual Luxation of the Temporomandibular Joint with Sedation and Local Anesthesia: A Case Series

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