Establishment of an intravenous conscious sedation service at a University Dental Clinic in Tanzania.

Karpal Singh Sohal, Frank Bald, Samwel Mwalutambi, Paulo J Laizer, David K Deoglas, Jeremiah Robert Moshy, Baraka Kileo, Noah Joshua, Sospeter Sewangi
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Abstract

Background: With advances in safety measures for anesthesia, conscious sedation has gained popularity in the field of dentistry and has become essential in dental practice worldwide. However, in Tanzania, intravenous (IV) sedation is rarely practiced in the dental field. Therefore, we report the establishment of sustainable IV conscious sedation in dental practices and subsequently train local OMS residents in Tanzania.

Methods: In 2019, intravenous conscious sedation was initiated at the University Dental Clinic of the Muhimbili University of Health and Allied Science (MUHAS), Tanzania. During the preparatory phase of the program, local oral and maxillofacial surgeons (OMSs) were given a series of lecture notes that concentrated on different aspects of IV conscious sedation in dentistry. During the on-site training phase, an oral surgeon from the United States joined the OMSs for case selection, IV-conscious sedation procedures, and patient follow-up. Patients were recruited from existing patient records at the MUHAS Dental Clinic.

Results: The first conscious IV sedation program in dentistry was successfully launched at the University Dental Clinic in Tanzania. The local team of OMSs was trained on the safe administration of sedative agents (midazolam or ketamine) to perform various minor surgical procedures in a dental office. Nine patients with different ages, body masses, and medical conditions benefited from the training. No complications were associated with IV conscious sedation in the dental office.

Conclusion: This was the first successful "hands-on" training on IV conscious sedation provided to OMSs in Tanzania. It laid the foundation for the sustainable care of patients with special needs requiring oral health-related care in the country.

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在坦桑尼亚一所大学牙科诊所建立静脉清醒镇静服务。
背景:随着麻醉安全措施的进步,清醒镇静在牙科领域越来越受欢迎,并在全球牙科实践中成为必不可少的。然而,在坦桑尼亚,静脉注射(IV)镇静在牙科领域很少实行。因此,我们报告在牙科实践中建立可持续的静脉清醒镇静,并随后培训坦桑尼亚当地OMS居民。方法:2019年,在坦桑尼亚Muhimbili卫生与联合科学大学(MUHAS)大学牙科诊所开始静脉清醒镇静。在计划的准备阶段,当地口腔颌面外科医生(OMSs)被给予了一系列的讲座笔记,集中在静脉清醒镇静在牙科的不同方面。在现场培训阶段,一名来自美国的口腔外科医生加入了oms,负责病例选择、静脉清醒镇静程序和患者随访。患者从MUHAS牙科诊所的现有患者记录中招募。结果:在坦桑尼亚的大学牙科诊所成功地启动了牙科领域的第一个有意识的静脉镇静项目。在牙科诊所进行各种小型外科手术时,对当地的oms小组进行了安全使用镇静剂(咪达唑仑或氯胺酮)的培训。9名不同年龄、体重和医疗条件的患者从培训中受益。在牙科诊所使用静脉清醒镇静无并发症。结论:这是坦桑尼亚首次成功为oms提供静脉清醒镇静的“实践”培训。它为该国需要口腔健康护理的特殊需要患者的可持续护理奠定了基础。
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