title: Deep Sedation for Pediatric Dental Procedures: Is this a Safe and Effective Option?
abstract: OBJECTIVE
  Sedation may be needed for safe, effective completion of pediatric dental procedures. Procedural sedation is performed in a children's hospital based dental office. The three sedation approaches: a propofol-only (P-O) approach (2-3 mg/kg titrated to the needed level of sedation), an approach that includes either i.v. ketamine (K+P) (0.25 or 0.5 mg/kg) or i.v. fentanyl (F+P) (0.5-1 mcg/kg) prior to propofol administration. We sought to determine safety and efficacy of various propofol based sedation protocols.
  
  
  METHODS
  Retrospective review of 222 patients receiving a propofol-only (P-O), ketamine+propofol (K+P) or fentanyl+propofol (F+P) approach.
  
  
  RESULTS
  There were 44 patients in P-O group, 154 in K+P group and 24 in F+P group with mean age (4.8±3.4 y) and mean weight (19.7±6.7 kg). All the patients completed procedures successfully. Mild hypoxemia occurred in 24% of cases and resolved with nasal cannula. Mean total dose of propofol was similar in all groups (P-O 8.2 mg/kg, K+P 9.5 mg/kg, F+P 9.6 mg/kg, p=0.15). Although procedure and recovery times were similar in all groups, discharge times in K+P group were significantly shorter than P-O group and F+P group respectively (K+P 9.35±8.93.min, P-O 13.57±10.42 min, F+P 10.42±4.40 p= 0.002).
  
  
  CONCLUSIONS
  Sedation can be accomplished safely and effectively in a children's hospital based dental office using propofol-based sedation.
authors.forename: Sheikh Sohail
authors.initials: SS
authors.lastname: Ahmed
authors.forename: Shawn R
authors.initials: SR
authors.lastname: Hicks
authors.forename: James E
authors.initials: JE
authors.lastname: Slaven
authors.forename: Mara E
authors.initials: ME
authors.lastname: Nitu
mesh_terms: D000759:Adjuvants, Anesthesia / Q000008:administration & dosage; D000762:Anesthesia Recovery Period; D000766:Anesthesia, Dental / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D002404:Catheterization / Q000295:instrumentation; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D054810:Deep Sedation / Q000379:methods*; D019140:Dental Care for Children / Q000379:methods*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007022:Hypotension / Q000209:etiology; D000860:Hypoxia / Q000209:etiology; D007649:Ketamine / Q000008:administration & dosage; D008297:Male; D010102:Oxygen Inhalation Therapy / Q000295:instrumentation; D010351:Patient Discharge; D015742:Propofol / Q000008:administration & dosage; D012189:Retrospective Studies; D012449:Safety
chemical_list: D000759:Adjuvants, Anesthesia; D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives; D007649:Ketamine; D005283:Fentanyl; D015742:Propofol
keywords: Financial Implications; Pediatric dental sedation; Propofol