Office-based ambulatory sedation--the use of the airway protector system during oral surgery: a prospective audit of the first 100 patients.
OBJECTIVE
To evaluate the efficacy of the "Airway Protector System" (APS), a simple homemade device used for airway control during office-based dental sedation.


METHODS
A prospective audit was performed in 100 severely dental phobic patients submitted to dental treatment in a dentist office under propofol sedation.


RESULTS
Sixty-eight females and 32 males were enrolled in this study. The mean age was 45 +/- 7 years (range, 18 to 67 years). A clear airway was obtained in 94 patients. Partial airway obstruction was observed in 4 patients but manual lifting of the jaw was enough to free the partial obstruction and dental treatment was uneventfully conducted. In 2 patients, the APS had to be converted to formal nasotracheal intubation because jaw-lifting maneuvers did not adequately relieve a partial airway obstruction. Sore throat was reported in 56 patients. In 27 cases, the patients rated the complaint as severe. No patient required a chest x-ray after sedation, as there was no clinical evidence of any pulmonary complication including dyspnea, cough, or fever.


CONCLUSIONS
We suggest that the concomitant use of a homemade cuffed nasopharyngeal airway with continuous suction facilitates airway control during deep levels of office-based sedation for dental treatment in severely dental phobic patients.
Klein
Moti
M
General Intensive Care Unit, Division of Anesthesiology and Critical Care, Soroka Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel. motiklein@yahoo.com
Weksler
Natan
N
Weksler
Doron
D
Bodner
Lipa
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000402:Airway Obstruction / Q000517:prevention & control*; D000556:Ambulatory Surgical Procedures / Q000295:instrumentation*; D000766:Anesthesia, Dental / Q000295:instrumentation*; D000779:Anesthetics, Local / Q000008:administration & dosage; D054869:Clinical Audit; D054810:Deep Sedation / Q000295:instrumentation*; D016854:Dental Anxiety / Q000517:prevention & control; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007440:Intubation / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009305:Nasopharynx; D019647:Oral Surgical Procedures / Q000295:instrumentation; D015742:Propofol / Q000008:administration & dosage; D011446:Prospective Studies; D013396:Suction / Q000295:instrumentation
D000779:Anesthetics, Local; D006993:Hypnotics and Sedatives; D015742:Propofol