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Intravenous sedation for adults with profound acquired brain injury undergoing dental treatment - a seven-year
Mili Doshi1, Ahmed Kahatab2, Louise Gallagher3
1Consultant in Special Care Dentistry, Royal Hospital for Neuro-disability, London, UK. mili.doshi@nhs.net.
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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