Morbidity and mortality from pharmacosedation and general anesthesia in the dental office

Krippaehne, James A.; Montgomery, Michael T.

doi:10.1016/0278-2391(92)90099-l

Cited by 45 publications

(6 citation statements)

References 3 publications

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“…During the second 7 years of practice, Rodgers 14 noted that complications associated with conscious sedation for dental procedures fell to 1.57%. Although most complications associated with sedation procedures are minor, some deaths have occurred 15,16 . In the 964 periodontal procedures reviewed in this article, 18 complications, all minor, were noted, for a rate of 1.87%, similar to that reported by Rodgers 14 .…”

Section: Discussionsupporting

confidence: 74%

“…▪ Preprocedural medical consultation for ASA Class II patients with significant medical conditions and all ASA Class III patients and referral to higher echelon of care for all ASA Class IV patients are required.▪ Use of properly maintained patient monitoring equipment is necessary.▪ Proper use of sedation medications in terms of dosage and administration is required.▪ All providers and staff should be properly trained in emergency management of respiratory and hemodynamic complications. What are the primary limitations to success in these cases? ▪ Improper use of sedation medications in terms of dosage and administration may result in severe consequences up to and including patient death 15 , 16 …”

Section: Discussionmentioning

confidence: 99%

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Intravenous Moderate Sedation as an Adjunct for Periodontal Surgery: A Retrospective Analysis of 964 Cases

Holtzclaw¹,

Hinze²,

Burnham

et al. 2014

Clin Adv Periodontics

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Introduction: Numerous articles have documented the safety of intravenous moderate sedation when used as an adjunct for dental procedures. These articles have traditionally focused on surgical procedures and demonstrate significant differences in duration for periodontal versus oral surgery cases. Periodontal procedures typically last longer than oral surgery procedures, and, when using intravenous moderate sedation, these time differences can be critical because longer procedures require additional medication use and place patients in prolonged periods of altered consciousness. Case Series: The goal of this retrospective review is to analyze intravenous moderate sedation records from multiple private practicing periodontists to evaluate a variety of data and how they relate to periodontal procedures. Evaluated data included patient demographics, procedure type, procedure duration, medication dosages, fluid administration, hemodynamic changes, respiratory changes, and complications. Intravenous sedation cases performed during the past 5 years at five private periodontal practices were evaluated. Conclusions: Intravenous moderate sedation using fentanyl and versed is a safe and effective adjunct for periodontal surgical procedures with minimal complications. Predictable changes in hemodynamic and respiratory levels will ensue when using these agents. Finally, practitioners using intravenous moderate sedation should schedule an additional 30 minutes of procedure time to account for preoperative and postoperative patient management.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Intravenous Moderate Sedation as an Adjunct for Periodontal Surgery: A Retrospective Analysis of 964 Cases

Holtzclaw¹,

Hinze²,

Burnham

et al. 2014

Clin Adv Periodontics

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“…When considering the risks associated with a GA, mortality is usually the first problem to jump to mind. However, death following dental GA in healthy children is relatively unlikely [1], morbidity is a much more common problem.…”

Section: Introductionmentioning

confidence: 99%

Morbidity following dental treatment of children under intubation general anaesthesia in a day‐stay unit

Atan

Ashley

Gilthorpe

et al. 2004

Int J Paed Dentistry

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“…Therefore we aim MRSS level 4 in our sedation practice and give preference to sevoflurane, which has lower blood-gas solubility compared to other inhalation agents, has fast-paced effect, which ends fast and does not cause airway irritation 16-18. When 2400 closed cases in the USA were evaluated, it was observed that 238 of these cases were pediatric, which involved respiratory problems different from adults and was concluded that the mortality rate could be decreased with better monitorization 9,19. Another study evaluated 95 cases in hospitals and private practice and concluded that 78% of cases where pulse oximeter monitoring was not present, unwanted occurrence was associated with mortality or neurological deficits whereas this rate decreased to 28% in patients who were monitorized with pulse oximeter 20.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, sedation depth may be increased in order to obtain deep sedation even general anesthesia and cardiorespiratory depression may develop. Even though appropriate anesthetic agents are used with recommended doses, unwanted effects of sedation can be seen8,9 and it is important to present how often these side effects occur and which risk factors trigger them. For these reasons, in this study, we aimed to share our experience, anesthetic agent chosen, associated postoperative complications, their frequencies and risk factors in pediatric patients who underwent tooth extraction under sedoanalgesia.…”

Section: Introductionmentioning

confidence: 99%

Pediatric tooth extractions under sedoanalgesia

Arpacı¹,

Işık²

2016

Pak J Med Sci

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Objective:The present study aims to evaluate intravenous ketamine and inhalation sedation in children, their unwanted side-effects and surgeon satisfaction.Methods:In this study, data of 922 children aged between 1-18 who underwent tooth extraction under sedoanalgesia in our department between September 2015-January 2016 were gathered and anesthesia approaches, unwanted side effects and surgical satisfaction was investigated. Postoperative recovery emergence agitation or delirium was evaluated with Watcha Behavior Scale (WBS).Results:Patients were grouped and compared according to acceptance of intravenous line placement (Group-1) or not (Group- 2). Group 1 received intravenous ketamine anesthesia (n=822), Group 2 received inhalation anesthesia with sevoflurane (n=100). Number of patients, age, weight and gender was significantly different in two groups. When side effects were investigated nausea was observed in 30 patients (3.6%), skin rashes were observed in 26 patients (3.2%) in Group-1 while skin rashes were observed in one patient (1%) in Group 2. 95% of surgeons reported intravenous anesthesia, 18% of surgeons reported inhalation anesthesia to be the anesthesia of choice. Emergence of postoperative recovery agitation (WBS≥3) was observed more frequent in Group 2 (p<0.05) than Group 1.Conclusion:Ketamine, which has analgesic, hypnotic and amnestic effects and which does not alter pharyngeal and laryngeal reflexes thus minimizes aspiration possibility, is a safe and effective anesthetic agent for tooth extractions of the pediatric population under sedoanalgesia.

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Morbidity and mortality from pharmacosedation and general anesthesia in the dental office

Cited by 45 publications

References 3 publications

Intravenous Moderate Sedation as an Adjunct for Periodontal Surgery: A Retrospective Analysis of 964 Cases

Intravenous Moderate Sedation as an Adjunct for Periodontal Surgery: A Retrospective Analysis of 964 Cases

Morbidity following dental treatment of children under intubation general anaesthesia in a day‐stay unit

Pediatric tooth extractions under sedoanalgesia

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