title: Complications of Moderate Sedation Versus Deep Sedation/General Anesthesia for Adolescent Patients Undergoing Third Molar Extraction.
abstract: OBJECTIVE
  To examine the complications resulting from moderate sedation versus deep sedation/general anesthesia for adolescent patients undergoing third molar extraction and determine whether any differences in complication risks exist between the 2 levels of sedation.
  
  
  METHODS
  We performed a prospective study of the Oral and Maxillofacial Surgery Outcomes System from January 2001 to December 2010. The primary predictor variable was the level of sedation, divided into 2 groups: moderate sedation versus deep sedation/general anesthesia. The primary outcome was the incidence of adverse complications resulting from the sedation level. Differences in the cohort characteristics were analyzed using the independent samples t test, χ(2) test, and analysis of variance, as appropriate. Multivariable logistic regression was used to measure the effect the level of sedation had on the adverse complication rate.
  
  
  RESULTS
  Patients in the moderate sedation group had a complication rate of 0.5%, and patients in the deep sedation/general anesthesia group had a complication rate of 0.9%. Compared with moderate sedation, deep sedation/general anesthesia did not pose a significantly increased risk of adverse anesthesia complications (adjusted odds ratio 1.63, 95% confidence interval 0.95 to 2.81; P = .077).
  
  
  CONCLUSIONS
  The results of our study have shown that the risk of adverse anesthesia complications is not increased when choosing between moderate and deep sedation/general anesthesia for adolescent patients undergoing third molar extraction.
authors.affiliation: Postgraduate Year 1 Resident, Department of Oral and Maxillofacial Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA. Electronic address: gino.inverso@uphs.upenn.edu.
authors.forename: Gino
authors.initials: G
authors.lastname: Inverso
authors.affiliation: Professor and Chair, Department of Oral and Maxillofacial Surgery, and Associate Dean for Hospital Affairs, University of Washington School of Dentistry, Seattle, WA.
authors.forename: Thomas B
authors.initials: TB
authors.lastname: Dodson
authors.affiliation: Senior Research Associate, American Association of Oral and Maxillofacial Surgeons, Rosemont, IL.
authors.forename: Martin L
authors.initials: ML
authors.lastname: Gonzalez
authors.affiliation: Associate Professor, Harvard School of Dental Medicine; and Director, Center for Applied Clinical Investigation, Massachusetts General Hospital, Boston, MA.
authors.forename: Sung-Kiang
authors.initials: SK
authors.lastname: Chuang
mesh_terms: D000293:Adolescent; D000766:Anesthesia, Dental / Q000009:adverse effects*; D000768:Anesthesia, General / Q000009:adverse effects*; D001007:Anxiety / Q000523:psychology; D001049:Apnea / Q000209:etiology; D001145:Arrhythmias, Cardiac / Q000209:etiology; D001808:Blood Vessels / Q000293:injuries; D015331:Cohort Studies; D016292:Procedural Sedation / Q000009:adverse effects*; D054810:Deep Sedation / Q000009:adverse effects*; D055191:Delayed Emergence from Anesthesia / Q000209:etiology; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007040:Hypoventilation / Q000209:etiology; D007826:Laryngismus / Q000209:etiology; D008297:Male; D008964:Molar, Third / Q000601:surgery*; D020250:Postoperative Nausea and Vomiting / Q000209:etiology; D011446:Prospective Studies; D053120:Respiratory Aspiration / Q000209:etiology; D018570:Risk Assessment; D013575:Syncope / Q000209:etiology; D014081:Tooth Extraction / Q000379:methods*; D016896:Treatment Outcome; D014839:Vomiting / Q000209:etiology
chemical_list: D006993:Hypnotics and Sedatives