title: A prospective randomised controlled study of patient-controlled propofol sedation in phobic dental patients.
abstract: The safety and effectiveness of patient-controlled propofol sedation was prospectively assessed in 18 healthy, phobic dental patients. Using a randomised, crossover design each patient received two sessions of equivalent dental treatment under patient-controlled or clinician-controlled propofol sedation. The patient-controlled technique used 29.8% less drug (time-weighted dose) than the clinician-controlled method (p = 0.011). There was a high correlation between number of demands and number of doses actually infused during the patient-controlled technique (r = 0.99, p < 0. 001). Clinically, the level of sedation was lighter and the degree of operator satisfaction was higher with patient-controlled sedation. Blood pressure and arterial oxygen saturation showed minimal changes and remained within normal ranges during both techniques. Patient-controlled sedation produced a greater reduction in dental and general anxiety compared with clinician-controlled sedation, but the difference did not reach statistical significance. Three times the number of patients expressed a preference for the patient-controlled, compared with the clinician-controlled, technique. Patient-controlled sedation provides safe and acceptable intra-operative anxiolysis for phobic dental patients, but with reduced propofol dosage.
authors.affiliation: Department of Sedation, Newcastle Dental Hospital & School, Richardson Road, Newcastle upon Tyne NE2 4AZ, UK.
authors.forename: N M
authors.initials: NM
authors.lastname: Girdler
authors.forename: D
authors.initials: D
authors.lastname: Rynn
authors.forename: J P
authors.initials: JP
authors.lastname: Lyne
authors.forename: K E
authors.initials: KE
authors.lastname: Wilson
mesh_terms: D000328:Adult; D016292:Procedural Sedation / Q000379:methods*; D018592:Cross-Over Studies; D003814:Dentistry, Operative; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010698:Phobic Disorders / Q000188:drug therapy*; D015742:Propofol / Q000627:therapeutic use*; D011446:Prospective Studies; D012646:Self Administration
chemical_list: D006993:Hypnotics and Sedatives; D015742:Propofol