The effect of supplemental oxygen on apnea and oxygen saturation during pediatric conscious sedation.
OBJECTIVE
This study compared the effect of supplemental oxygen (O2) on pediatric patients' apnea status and oxyhemoglobin saturation during: 1) conscious sedation for dental procedures and 2) the recovery period following sedation.


METHODS
Fourteen child patients (mean age 42 months) sedated with 50 mg/Kg chloral hydrate, 25 mg hydroxyzine pamoate, and 1.5 mg/Kg meperidine were treated for two separate appointments. The patients received supplemental O2 via nasal cannulae at random at one of the two appointments. Following the operative period, all patients were monitored sitting upright for an additional 15 min.


RESULTS
Intraoperative results showed that the risk of apnea was 39% (11/28), with apneic events distributed equally between O2 and non-O2 supplemented sedations. The overall risk of desaturation was 29% (8/28). Mean SpO2 was always elevated with O2 supplementation and the mean difference in O2 versus non-O2 was statistically significant. The risk of apnea in the postoperative period was 7% (1/14) for both the non-O2 and O2-supplemented patients. The risk of desaturation in the postoperative period was 11% (3/28) with one desaturation in a non-O2 and two desaturations in O2-supplemented patients.


CONCLUSIONS
We conclude that intraoperative O2 supplementation prevents desaturations even in the presence of apnea during pediatric conscious sedation.
Rohlfing
G K
GK
Department of Pediatric Dentistry, School of Dentistry, University of North Carolina at Chapel Hill, USA.
Dilley
D C
DC
Lucas
W J
WJ
Vann
W F
WF
D000759:Adjuvants, Anesthesia / Q000008:administration & dosage; D000402:Airway Obstruction / Q000150:complications; D000762:Anesthesia Recovery Period; D000766:Anesthesia, Dental; D000779:Anesthetics, Local / Q000008:administration & dosage; D001049:Apnea / Q000097:blood / Q000517:prevention & control*; D002675:Child, Preschool; D002697:Chloral Hydrate / Q000008:administration & dosage; D016292:Procedural Sedation; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006919:Hydroxyzine / Q000008:administration & dosage; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008614:Meperidine / Q000008:administration & dosage; D016343:Monitoring, Intraoperative; D008991:Monitoring, Physiologic; D010100:Oxygen / Q000008:administration & dosage / Q000097:blood*; D010102:Oxygen Inhalation Therapy; D010108:Oxyhemoglobins / Q000378:metabolism; D014066:Palatine Tonsil / Q000473:pathology; D011184:Postoperative Period; D012307:Risk Factors
D000759:Adjuvants, Anesthesia; D000779:Anesthetics, Local; D006993:Hypnotics and Sedatives; D010108:Oxyhemoglobins; D006919:Hydroxyzine; D002697:Chloral Hydrate; D008012:Lidocaine; D008614:Meperidine; D010100:Oxygen