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J Clin Pediatr Dent ; 40(2): 156-60, 2016.
Article in English | MEDLINE | ID: mdl-26950819

ABSTRACT

OBJECTIVE: Sedation may be needed for safe, effective completion of pediatric dental procedures. Procedural sedation is performed in a children's hospital based dental office. The three sedation approaches: a propofol-only (P-O) approach (2-3 mg/kg titrated to the needed level of sedation), an approach that includes either i.v. ketamine (K+P) (0.25 or 0.5 mg/kg) or i.v. fentanyl (F+P) (0.5-1 mcg/kg) prior to propofol administration. We sought to determine safety and efficacy of various propofol based sedation protocols. STUDY DESIGN: Retrospective review of 222 patients receiving a propofol-only (P-O), ketamine+propofol (K+P) or fentanyl+propofol (F+P) approach. RESULTS: There were 44 patients in P-O group, 154 in K+P group and 24 in F+P group with mean age (4.8±3.4 y) and mean weight (19.7±6.7 kg). All the patients completed procedures successfully. Mild hypoxemia occurred in 24% of cases and resolved with nasal cannula. Mean total dose of propofol was similar in all groups (P-O 8.2 mg/kg, K+P 9.5 mg/kg, F+P 9.6 mg/kg, p=0.15). Although procedure and recovery times were similar in all groups, discharge times in K+P group were significantly shorter than P-O group and F+P group respectively (K+P 9.35±8.93.min, P-O 13.57±10.42 min, F+P 10.42±4.40 p= 0.002). CONCLUSION: Sedation can be accomplished safely and effectively in a children's hospital based dental office using propofol-based sedation.


Subject(s)
Anesthesia, Dental/methods , Deep Sedation/methods , Dental Care for Children/methods , Adjuvants, Anesthesia/administration & dosage , Anesthesia Recovery Period , Anesthetics, Intravenous/administration & dosage , Catheterization/instrumentation , Child , Child, Preschool , Cohort Studies , Female , Fentanyl/administration & dosage , Follow-Up Studies , Humans , Hypnotics and Sedatives/administration & dosage , Hypotension/etiology , Hypoxia/etiology , Ketamine/administration & dosage , Male , Oxygen Inhalation Therapy/instrumentation , Patient Discharge , Propofol/administration & dosage , Retrospective Studies , Safety
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