Abstract:
OBJECTIVE:As an alternative to general anaesthesia for dentistry.attention has been focused on other, apparently safer, methods of pain and anxiety control. We have undertaken a study to evaluate the safety and efficacy of intravenous sedation using propofol target-controlled infusions. DESIGN:We describe a retrospective observational analysis of propofol conscious sedation as an adjunct to local anaesthesia for patients undergoing simple or surgical exodontia. All the patients were assessed,selected and treated according to standardized hospital sedation protocols. Experienced anaesthetists used a standard regimen, with ECG, pulse oximetry and non-invasive blood pressure monitoring. A standard sedation record was completed for each patient. The initial target plasma propofol concentration was set at 1.5 microg ml(-1), adjusted thereafter to achieve the desired level of sedation. Any adverse events were recorded. SETTING:Birmingham Dental Hospital. SUBJECTS:Three hundred consecutive sedation episodes in adult dental phobic patients requiring exodontia under local anaesthesia. RESULTS:Sedation and treatment were satisfactorily completed in 297 patients. The mean target propofol concentration required was 2.1 microg ml(-1), (SD = 0.47 microg ml(-1), range 1 - 4 microg ml(-1)). General anaesthesia occurred in two cases (target concentration (TC) 2 microg ml(-1)), over sedation in 11 cases(TC 1 - 3 microg ml(-1)), and transient hypoxaemia in 7 cases (TC 1.8 - 2.5 microg ml(-1)). CONCLUSION:Intravenous sedation with target-controlled propofol infusions is effective. However, significant adverse effects may occur at target concentrations below 2.1 microg ml(-1). Only anaesthetists working in an appropriate environment should practise this technique.
journal_name
Br Dent Jjournal_title
British dental journalauthors
Blayney MR,Ryan JD,Malins AFdoi
10.1038/sj.bdj.4810031subject
Has Abstractpub_date
2003-04-26 00:00:00pages
450-2; discussion 443issue
8eissn
0007-0610issn
1476-5373pii
4810031journal_volume
194pub_type
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