title: Use of bispectral index system (BIS) to Monitor Enteral Conscious (moderate) sedation during general dental procedures.
abstract: Although dental board regulations for the provision of in-office enteral conscious (oral) sedation vary widely with respect to training and pharmacologic strategies, they agree on the use of drugs that are inherently safe, the use of pulse oximetry and the availability of emergency equipment, including pharmacologic antagonists. Patient safety is of greatest concern and is best addressed by appropriate selection of patients, adequate training of personnel and appropriate monitoring of patients. Readings from bispectral index system (BIS) monitors, which use electroencephalographic signals, correlate accurately with depth of sedation during nondissociative general anesthesia of adults and children in the operating room setting. The usefulness of such monitoring as an adjunct to other forms of monitoring of in-office enteral sedation in the dental setting may represent the next important application of this tool, adding a further level of safety for the patient and another level of predictability for the practitioner. This paper reviews the current evidence supporting this new technique, presenting data from 20 procedures in which BIS monitoring during in-office enteral sedation was employed in a community dental practice.
authors.affiliation: Kalispell Regional Medical Centre, 310 Sunnyview Lane, Kalispell, MT 59901-3199, USA. mdonaldson@krmc.org
authors.forename: Mark
authors.initials: M
authors.lastname: Donaldson
authors.forename: Jason H
authors.initials: JH
authors.lastname: Goodchild
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000766:Anesthesia, Dental / Q000379:methods*; D014151:Anti-Anxiety Agents / Q000008:administration & dosage; D015924:Blood Pressure Monitors; D016292:Procedural Sedation / Q000379:methods*; D003243:Consciousness / Q000187:drug effects; D004569:Electroencephalography / Q000379:methods*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D010092:Oximetry; D014229:Triazolam / Q000008:administration & dosage
chemical_list: D014151:Anti-Anxiety Agents; D006993:Hypnotics and Sedatives; D014229:Triazolam