A retrospective analysis of intravenous deep sedation for uncooperative pediatric patients undergoing oral treatment in outpatient clinic

To retrospectively analyze the efficacy of intravenous deep sedation for uncooperative pediatric patients undergoing oral treatment in outpatient clinic.The uncooperative pediatric patients, aged 2-10 yr, with an expected treatment time<2 h, who underwent oral treatment in outpatient clinic from November 2015 to October 2018, were selected.Dexmedetomidine was delivered via nasal spray, midazolam was taken orally or delivered via nasal spray, and sevoflurane was inhaled for sedation before treatment.Propofol was administered by target-controlled infusion during treatment to make patients achieve deep sedation.A total of 251 patients were enrolled and successfully completed oral therapy.Sedation before treatment: 154 cases (61.4%) received dexmedetomidine via nasal spray delivery, 14 cases (5.6%) received oral midazolam, 3 cases (1.2%) received midazolam via nasal spray delivery, and 80 cases (31.9%) inhaled sevoflurane, and ideal sedation (Ramsay sedation score ≥4) was achieved in each pediatric patients.Temporary interruption of oral treatment due to physical activity occurred in 39 cases (15.5%), coughing occurred in 39 cases (15.5%), transient hypoxemia (time< 30 s) was found in 32 cases (12.9%), and these conditions returned to normal within 30 s through pausing the operation, deepening anesthesia, oral suction, lower jaw thrust or inhaling oxygen, etc.Only 1 case developed emergence agitation (Riker sedation-agitation scale score 5) during stay in the recovery room.No patients developed complications such as sore throat, vomiting, aspiration or obstruction of the upper respiratory tract.Intravenous deep sedation technique can be used for oral treatment in outpatient clinic in uncooperative pediatric outpatients and raise comfort of medical treatment for pediatric patients. Key words: Deep sedation; Pediatric dentistry; Propofol; Outpatient