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. 2024 Dec 30;10(1):101.
doi: 10.1038/s41405-024-00289-2.

Intravenous sedation for adults with profound acquired brain injury undergoing dental treatment - a seven-year service evaluation

Mili Doshi  1 , Ahmed Kahatab  2 , Louise Gallagher  3 , Ria Prasad  4 , Richard Fitzgerald  5
Affiliations

Intravenous sedation for adults with profound acquired brain injury undergoing dental treatment - a seven-year service evaluation

Mili Doshi et al. BDJ Open. .

Abstract

Background: Dental treatment may not be possible for patients with a profound acquired brain injury without pharmacological support. Intravenous (IV) sedation with midazolam is a widely accepted, safe, and effective mode of treatment for people with a disability, but there is limited evidence in this patient cohort.

Aims: This evaluation aimed to review the IV sedation service for patients with profound acquired brain injury within the dental department at the Royal Hospital for Neuro-disability.

Method: This study was a retrospective service evaluation of IV sedation for dental treatment over seven years. Descriptive statistics are presented.

Results: In total, 303 episodes of sedation were undertaken at the Royal Hospital of Neurodisability over seven years. Ninety-two percent were graded with an American Society of Anaesthesiologists (ASA) grade 3, and one-third had a history of stroke. 91% had treatment completed successfully. Complications occurred in 7.9% of cases, but all were minor, with no resulting patient harm (e.g. a transient drop in oxygen saturation).

Conclusion: Dentist-led IV sedation with midazolam is safe and effective for dental treatment for patients with a profound acquired brain injury in a specialised setting with experienced clinicians.

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Conflict of interest statement

Competing interests: The authors declare no competing interests. Ethical approval: Ethical approval was not required for this study based on the Health Research Authority toolkit: this is a retrospective service evaluation, the participants were not randomised, and there was no change to usual clinical practice.

Figures

Fig. 1
Fig. 1
Dose (mg) of midazolam administered.
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