A preliminary study on oxygen saturation levels of patients during periodontal surgery with and without oral conscious sedation using diazepam.
BACKGROUND
Stress and anxiety alter respiratory rate and thereby alter oxygen saturation in the blood. Management of psychological stress in the dental office may help maintain blood gas homeostasis. One method of stress management is through the use of preoperative oral sedation.


METHODS
The study population consisted of 13 patients scheduled to receive two quadrants of periodontal surgery at two different appointments. A randomized split-mouth crossover design was used with one quadrant of surgery involving preoperative oral sedation (diazepam) and local anesthetic, and the second using local anesthetic only. Oxygen saturation was monitored by pulse oximetry, which recorded the number of times saturation dropped below 95% in a given time period. Data were recorded at 5 time periods: 1) baseline; 2) from time of anesthetic administration to 20 minutes into surgery; 3) 21 to 40 minutes; 4) 41 to 60 minutes; and 5) 61 to 80 minutes into the surgery. Data were analyzed by a two-factor repeated measures ANOVA. The two within-group factors were treatment group and time.


RESULTS
Results indicated no significant interaction between time and treatment (P > .05). However, data for groups over time suggested a trend supporting an interaction. The eta2 value of 0.124 suggested a moderate effect favoring the diazepam treatment. No significant difference was noted for the main effect of treatment and time. However, the eta2 value of 0.24 for treatment effect (diazepam versus no diazepam) suggested a meaningful difference between groups. Similarly the eta2 value of 0.135 for time suggested a moderate effect over time within-subjects.


CONCLUSIONS
This study indicates that diazepam given orally in adult dosages does not cause significant respiratory depression, and is generally safe for those healthy patients who may require slight to mild sedation during periodontal surgery.
Aeschliman
Steven D
SD
Department of Periodontics, School of Dentistry, University of Missouri-Kansas City, Kansas City, Missouri 64108, USA.
Blue
Mark S
MS
Williams
Karen B
KB
Cobb
Charles M
CM
MacNeill
Simon R
SR
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000766:Anesthesia, Dental; D000779:Anesthetics, Local / Q000008:administration & dosage; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D016292:Procedural Sedation; D018592:Cross-Over Studies; D016854:Dental Anxiety / Q000517:prevention & control; D003975:Diazepam / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D010092:Oximetry; D010100:Oxygen / Q000097:blood*; D010510:Periodontal Diseases / Q000601:surgery*; D011292:Premedication; D013315:Stress, Psychological / Q000517:prevention & control; D013997:Time Factors
D000779:Anesthetics, Local; D014151:Anti-Anxiety Agents; D003975:Diazepam; D010100:Oxygen