Safety of deep intravenous propofol sedation in the dental treatment of children in the outpatient department

Wu, Xiaoran; Liu, Yun; Li, Binghua; Zhou, Dan; Cheng, Tong; Ma, Tianyu; Yang, Xu-Dong; Xia, Bin

doi:10.1016/j.jds.2022.11.013

Cited by 4 publications

(8 citation statements)

References 25 publications

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“…Our findings confirmed that propofol-based sedation could be used safely and effectively in young children who were unable to cooperate during dental procedures, consistent with the previous literature [8,[36][37][38]. The use of propofol has become increasingly popular for moderate-to-deep sedation in office-based procedures over the past few decades.…”

Section: Discussionsupporting

confidence: 91%

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Application of Bispectral Index System (BIS) Monitor to Ambulatory Pediatric Dental Patients under Intravenous Deep Sedation

Chen

Shen

et al. 2023

Diagnostics

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Purpose Intravenous sedation has been well accepted to allow dental restoration in uncooperative children while avoiding aspiration and laryngospasm; however, intravenous anesthetics such as propofol may lead to undesired effects such as respiratory depression and delayed recovery. The use of the bispectral index system (BIS), a monitoring system reflective of the hypnotic state, is con-troversial in the reduction in the risk of respiratory adverse events (RAEs), recovery time, the in-travenous drug dosage, and post-procedural events. The aim of the study is to evaluate whether BIS is advantageous in pediatric dental procedures. Methods A total of 206 cases, aged 2–8 years, receiving dental procedures under deep sedation with propofol using target-controlled infusion (TCI) technique were enrolled in the study. BIS level was not monitored in 93 children whereas it was for 113 children, among which BIS values were maintained between 50–65. Physiological variables and adverse events were recorded. Statistical analysis was conducted using Chi-square, Mann Whitney U, Independent Samples t and Wilcoxon signed tests, with a p value of <0.05 considered to be statistically significant. Results Although no statistical significance in the post-discharge events and total amount of propofol used was observed, a clear significance was identified in periprocedural adverse events (hypoxia, apnea, and recurrent cough, all p value < 0.05) and discharge time (63.4 ± 23.2 vs. 74.5 ± 24.0 min, p value < 0.001) between these two groups. Conclusions The application of BIS in combination with TCI may be beneficial for young children undergoing deep sedation for dental procedures.

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Section: Discussionsupporting

confidence: 91%

“…The incidence of adverse events observed during the dental procedure is summarized in Table 2. We observed 132 episodes of perioperative respiratory adverse events (RAEs), with hypoxia being the most common, occurring 47 times, followed by apnea (38), recurrent coughing (16), bronchospasm (3), and laryngospasm (2).…”

Section: Primary Outcomementioning

confidence: 99%

Application of Bispectral Index System (BIS) Monitor to Ambulatory Pediatric Dental Patients under Intravenous Deep Sedation

Chen

Shen

et al. 2023

Diagnostics

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“…Previous retrospective study revealed that the duration of treatment was independent risk factor of intraoperative desaturation, while choking cough and suction were significantly associated with it. 4 We also found that the children in dexmedetomidine group had less choking cough and required less suction. The effect of dexmedetomidine to reduce catecholamine and gland secretions may play an important role in this aspect.…”

Section: Discussionsupporting

confidence: 51%

“…In the process of deep sedation management, venipuncture stands as an essential procedure. 4 However, children presenting to us – the anesthesiology department – are frequently exceptional. Most of these children have distinctive fear, anxiety, and refuse any invasive operation especially venipuncture, which leads to difficulty of the whole treatment.…”

Section: Discussionmentioning

confidence: 99%

Dexmedetomidine versus midazolam as intranasal premedication for intravenous deep sedation in pediatric dental treatment

Cheng¹,

Liu²,

Li³

et al. 2024

Journal of Dental Sciences

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“…In pediatric dentistry, various types of sedation are used to cater to the needs of young patients [8][9][10][11]. Moderate or conscious sedation is characterized by the maintenance of the patient's protective reflexes and airway patency [8][9][10][11][12]. Furthermore, the patient remains responsive to physical and verbal stimuli [9,10].…”

Section: Introductionmentioning

confidence: 99%

Retrospective evaluation of pediatric dental treatments under deep sedation

2024

Journal of Clinical Pediatric Dentistry

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This study identified the dental treatment modalities administered to patients undergoing dental procedures under deep sedation and examined potential relations among treatment types, age, gender and tooth types. This study protocol included data from 502 patients, including a total of 5141 teeth, who underwent dental procedures under deep sedation between October 2022 and October 2023. The dental treatments were categorized based on primary types and subtypes. Subsequently, this study examined the associations between treatment types and age, gender and tooth type. Data were analyzed using the Chi-Square test, with the significance level set at 5%. Most patients (76.9%) were aged 0–6 years, and 93.4% of the treated teeth were primary teeth. The predominant treatment was restorative therapy (61.6%), followed by extraction (27.2%), endodontic treatment (6.1%), and preventive treatment (5.1%). Among restorative materials, compomer was the most frequently applied (49.8%). Significant differences between the treatment types were observed in terms of age group and tooth type (p < 0.001 for both) but not gender (p = 0.920). Based on our findings, restorative treatments and tooth extraction are the most frequently performed procedures, whereas endodontic treatments are performed less frequently under deep sedation.

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Safety of deep intravenous propofol sedation in the dental treatment of children in the outpatient department

Cited by 4 publications

References 25 publications

Application of Bispectral Index System (BIS) Monitor to Ambulatory Pediatric Dental Patients under Intravenous Deep Sedation

Application of Bispectral Index System (BIS) Monitor to Ambulatory Pediatric Dental Patients under Intravenous Deep Sedation

Dexmedetomidine versus midazolam as intranasal premedication for intravenous deep sedation in pediatric dental treatment

Retrospective evaluation of pediatric dental treatments under deep sedation

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