Conscious sedation for dentistry: an update

Craig, David; Wildsmith, J.A.W.

doi:10.1038/bdj.2007.1105

Cited by 38 publications

(20 citation statements)

References 1 publication

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“…It is disappointing that A&E departments administering propofol sedation can erroneously be called safe when the airway event rate is 80 ⁄ 1000 [17], almost 30-fold higher than those described in anaesthetists. It has been stated that safety for alternative or non-standard techniques of sedation should be demonstrated in hundreds of patients [18]. We believe we have done that and more, but that our A&E colleagues fall far short in that respect.…”

Section: Discussionmentioning

confidence: 86%

Sedation for oocyte retrieval using target controlled infusion of propofol and incremental alfentanil delivered by non‐anaesthetists

Edwards¹,

Kinsella

Shaw

et al. 2010

Anaesthesia

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SummaryOocyte retrieval is a procedure where sedation is recommended. This paper presents the process of setting up a new, non-anaesthetist delivered service in our institution, the development of safety systems and the audit data we have used to assure quality, effectiveness and safety. Logbook data were collected for 4342 cases, with detailed audit data collected for 260 cases. Safety is acceptable with a respiratory adverse incident rate of 0.5 ⁄ 1000 (95% CI 0.1-1.6 ⁄ 1000 cases). Unplanned, direct anaesthetic assistance was required in 3.5 ⁄ 1000 cases (95% CI 1.7-5.3 ⁄ 1000 cases). Anaesthetic advice was required in 7.5% cases (95% CI 4.2-10.7%) at the inception of the service, but rarely once established: 0.6% (95% CI 0.2-1.0%). Nearly all patients (99%) would have the same sedation method again, no patients required admission, and patients' co-operation was judged by the operating surgeon as very good or good in 91% of cases.

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Section: Discussionmentioning

confidence: 86%

Sedation for oocyte retrieval using target controlled infusion of propofol and incremental alfentanil delivered by non‐anaesthetists

Edwards¹,

Kinsella

Shaw

et al. 2010

Anaesthesia

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show abstract

“…This would allow many more patients undergoing unpleasant procedures to benefit from the advantages that propofol sedation offers. Further work is now required to assess its safety and efficacy in large numbers of different patient populations .…”

Section: Discussionmentioning

confidence: 99%

Reaction time‐monitored patient‐maintained propofol sedation: a pilot study in oral surgery patients

et al. 2013

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SummaryPrevious volunteer studies of an effect-site controlled patient-maintained sedation system using propofol have demonstrated a risk of oversedation. We have incorporated a reaction time monitor into the handset to add an individualised patient-feedback mechanism. This pilot study assessed if the reaction time-feedback modification would prove safe and effective in 20 healthy patients receiving sedation while undergoing oral surgery. All patients successfully sedated themselves without reaching any unsafe endpoints. All 20 maintained verbal contact throughout. The mean (SD) lowest peripheral blood oxygen saturation was 98.0 (2.1)% breathing room air. No patient required supplementary oxygen. The mean (SD) maximum effect-site propofol concentration reached was 1.6 (0.5) lg.ml À1. The present system was found to be safe and effective, allowing oral surgery treatment under conscious sedation, but preventing oversedation. Effect-site controlled, patient-maintained sedation with propofol allows the patient to control target controlled infusions of propofol, and hence his/her level of sedation, using a hand-held demand button. The system sets a target effect-site concentration [1] at a low level initially, which can be increased incrementally by the patient pressing the handset button twice within 1 s. The system increases the plasma concentration up to 100% greater than the target effect-site concentration to 'force' the drug rapidly into the effect site, and then reduces the plasma concentration as the target effect-site concentration is approached. Instead of a traditional time-based lockout, the patient is not able to obtain a further increment until the plasma concentration decreases to within 10% of the target effect-site concentration -an 'effect-site lockout'. As the brain is the site of action of propofol, this allows for equilibration between the blood and brain. This technique was found by our group to be safe and effective in patients having dental surgery [2], but the potential for oversedation was demonstrated in volunteers who were instructed to try deliberately to oversedate themselves [3][4][5].

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“…16 Nitröz oksit sedasyonu bu kriterleri büyük oranda içe-ren ve uzun zamandır birçok ülkede kullanılan bir teknik olup, günümüzde ağız cerrahisi işlemlerinde sedasyon amacıyla uygulanan yaygın yöntemlerden biridir. 2,4,24,[34][35][36][37] Hierons ve arkadaşları 36 , dental kaygıya sahip yetişkin hasta grubunda basit ve komplike diş çekim-leri esnasında kullanılan nitröz oksit/oksijen sedasyonunun postoperatif dönemde dental kaygı düzeyini azaltabileceği sonucunu bildirmiştir. Yazarlar minor oral cerrahi işlemler uygulanacak kaygı düzeyine sahip hastalarda lokal anestezi ile birlikte nitröz oksit/oksijen sedasyonu kullanımının yararlı olabileceğini ifade etmiştir.…”

Section: Nitröz Oksit/oksijen Sedasyonunun Ağız Cerrahisinde Kullanımıunclassified

Ni̇tröz Oksi̇t/Oksi̇jen Sedasyonu Ve Ağiz Cerrahi̇si̇nde Kullanim Alanlari

Ergüven¹,

Işık²

2015

Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi

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Sedation choice for oral surgical procedures must include several features such as, wide safety margin, easy to administrate, no interference with treatment, rapid onset, able to titrate and low environmental/ occupational hazards. Nitrous oxide/oxygen sedation meets most of these criteria and it is one of the common methods for achieving sedation currently. The aim of this review is to inform about nitrous oxide/oxygen sedation and its utilization in the fields of oral surgery in the light of the current literature.

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Conscious sedation for dentistry: an update

Cited by 38 publications

References 1 publication

Sedation for oocyte retrieval using target controlled infusion of propofol and incremental alfentanil delivered by non‐anaesthetists

Sedation for oocyte retrieval using target controlled infusion of propofol and incremental alfentanil delivered by non‐anaesthetists

Reaction time‐monitored patient‐maintained propofol sedation: a pilot study in oral surgery patients

Ni̇tröz Oksi̇t/Oksi̇jen Sedasyonu Ve Ağiz Cerrahi̇si̇nde Kullanim Alanlari

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