Computer controlled infusion of propofol for conscious sedation in dental treatment.
OBJECTIVE
To assess a drug delivery system that can rapidly achieve and maintain a constant blood concentration of Propofol (2,6 di-isopropyl phenol) which, in subanaesthetic doses, is an effective intravenous sedative for treating anxious or handicapped patients in dentistry.


METHODS
The clinical use of a computer controlled infusion system to induce and maintain conscious sedation with propofol was prospectively studied. Based on a 3-compartment pharmacokinetic model, the system calculates the initial bolus dose and infusion rates to achieve a user-selected target blood concentration.


METHODS
Amsterdam Center for Special Dental Care.


METHODS
89 patients attending for dental treatment.


RESULTS
Treatment could be performed within 2 minutes after the onset of the infusion. The median therapeutic target blood propofol concentration was 2.5 micrograms/ml and the median recovery time was 9 minutes. Transient oversedation (38 procedures) could easily be treated by decreasing the target concentration. No adverse cardiorespiratory effects resulted from propofol sedation. Venous blood propofol concentrations were measured in 25 anxious patients. The kinetic data set used in this study underestimated the distribution and elimination of propofol in our patients.


CONCLUSIONS
Computer controlled infusion of propofol can provide satisfactory and safe conscious sedation in dental patients.
Oei-Lim
V L
VL
Department of Anaesthesiology, Academic Medical Center, University of Amsterdam, The Netherlands.
Kalkman
C J
CJ
Makkes
P C
PC
Ooms
W G
WG
Hoogstraten
J
J
D000293:Adolescent; D000328:Adult; D000762:Anesthesia Recovery Period; D000766:Anesthesia, Dental; D001794:Blood Pressure / Q000187:drug effects; D003201:Computers; D016292:Procedural Sedation; D016854:Dental Anxiety / Q000517:prevention & control; D003729:Dental Care; D003730:Dental Care for Persons with Disabilities; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics; D007260:Infusion Pumps; D007262:Infusions, Intravenous; D008607:Intellectual Disability; D008297:Male; D008875:Middle Aged; D008956:Models, Chemical; D010100:Oxygen / Q000097:blood; D015742:Propofol / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics; D011446:Prospective Studies; D012119:Respiration / Q000187:drug effects; D012449:Safety; D013997:Time Factors
D006993:Hypnotics and Sedatives; D010100:Oxygen; D015742:Propofol