Patient-maintained sedation for oral surgery using a target-controlled infusion of propofol - a pilot study

Abstract

Objective: To assess the safety and efficacy of a new patient-maintained propofol system for conscious sedation in dentistry.

Design: Prospective clinical trial

Setting: Department of Sedation, Glasgow Dental Hospital and School, 2001

Subjects and methods: Patients scheduled for oral surgery with conscious sedation. Exclusions included ASA IV -V, inability to use the handset, opioid use and severe respiratory disease.

Interventions: Patients were given intravenous propofol to a level of 1.0 microg/ml (reducing from 1.5 microg/ml) using a target controlled infusion system, they then controlled their sedation level by double-clicking a handset which on each activation increased the propofol concentration by 0.2 microg/ml.

Main outcome measures: Oxygen saturation, patient satisfaction, and surgeon satisfaction.

Results: Twenty patients were recruited, 16 female and four male. Nineteen patients completed sedation and treatment successfully. Mean lowest oxygen saturation was 94%. No patients were over-sedated. All patients successfully used the system to maintain a level of sedation adequate for their comfort. Patient and surgeon satisfaction were consistently high.

Conclusions: Initial experience with this novel system has confirmed safety, patient satisfaction and surgeon satisfaction.