Safety of deep sedation in an urban oral and maxillofacial surgery training program

J Oral Maxillofac Surg. 2011 Aug;69(8):2112-9. doi: 10.1016/j.joms.2011.04.017.

Abstract

Purpose: To study the safety of deep sedation in an urban-based oral maxillofacial surgery training program.

Materials and methods: Charts of patients undergoing an intravenous sedation from January 2005 through December 2009 were reviewed. Data recorded included age, gender, type of procedures performed, and intravenous medications. Patients were divided in 2 groups depending on whether they received a general anesthetic agent (propofol or ketamine) or not. Anesthesia complications and failures were recorded and categorized.

Results: In total, 1,167 intravenous sedations were recorded. Eight patients developed adverse reactions, 3 of which required further evaluation in the emergency department. In addition, 7 intravenous sedations needed to be aborted because of patient agitation and combativeness. No deaths or long-term morbidities were reported.

Conclusions: The safety of deep sedation in an urban-based oral maxillofacial training program is similar to office-based anesthesia. Sedations failures may be attributed to paradoxical benzodiazepine reactions.

MeSH terms

  • Adjuvants, Anesthesia / administration & dosage
  • Adjuvants, Anesthesia / adverse effects
  • Adult
  • Age Factors
  • Aggression / drug effects
  • Akathisia, Drug-Induced / etiology
  • Ambulatory Surgical Procedures
  • Anesthetics, Intravenous / administration & dosage
  • Anesthetics, Intravenous / adverse effects
  • Child
  • Deep Sedation* / adverse effects
  • Dental Service, Hospital*
  • Diazepam / administration & dosage
  • Diazepam / adverse effects
  • Female
  • Fentanyl / administration & dosage
  • Fentanyl / adverse effects
  • Humans
  • Hypnotics and Sedatives / administration & dosage
  • Hypnotics and Sedatives / adverse effects
  • Injections, Intravenous
  • Internship and Residency
  • Ketamine / administration & dosage
  • Ketamine / adverse effects
  • Male
  • Midazolam / administration & dosage
  • Midazolam / adverse effects
  • Middle Aged
  • Oral Surgical Procedures*
  • Postoperative Complications / chemically induced
  • Propofol / administration & dosage
  • Propofol / adverse effects
  • Safety*
  • Sex Factors
  • Surgery, Oral / education
  • Urban Health Services*
  • Young Adult

Substances

  • Adjuvants, Anesthesia
  • Anesthetics, Intravenous
  • Hypnotics and Sedatives
  • Ketamine
  • Diazepam
  • Midazolam
  • Fentanyl
  • Propofol