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The effect of supplemental oxygen on apnea and oxygen saturation during pediatric conscious sedation
G K Rohlfing1, D C Dilley, W J Lucas
1Department of Pediatric Dentistry, School of Dentistry, University of North Carolina at Chapel Hill, USA.
Insights
Supplemental oxygen (O2) during pediatric conscious sedation prevents desaturation, even with apnea. Postoperative oxygen levels remained stable with or without O2, indicating intraoperative O2 is key for safety.
Area of Science:
- Pediatric Anesthesiology
- Sedation Monitoring
- Respiratory Physiology
Background:
- Conscious sedation in pediatric dental procedures carries risks of apnea and desaturation.
- Monitoring oxyhemoglobin saturation (SpO2) is crucial during and after sedation.
Purpose of the Study:
- To compare the effects of supplemental oxygen (O2) on apnea and SpO2 in pediatric patients.
- To evaluate O2's impact during conscious sedation and the subsequent recovery period.
Main Methods:
- Fourteen pediatric patients (mean age 42 months) received conscious sedation with chloral hydrate, hydroxyzine pamoate, and meperidine.
- Supplemental O2 via nasal cannulae was administered randomly at one of two separate dental appointments.
- Patients were monitored for 15 minutes post-sedation while sitting upright.
Main Results:
- Intraoperative apnea risk was 39%, with equal distribution between O2 and non-O2 groups.
- Intraoperative desaturation risk was 29%, with significantly higher SpO2 when O2 was supplemented.
- Postoperative apnea risk was 7% in both groups; desaturation risk was 11% (1/28 non-O2, 2/28 O2).
Conclusions:
- Intraoperative O2 supplementation effectively prevents desaturation during pediatric conscious sedation.
- Supplemental O2 does not appear to increase postoperative apnea or desaturation risks.
- This finding supports the use of intraoperative O2 to enhance safety in pediatric sedation.
Purpose:
This study compared the effect of supplemental oxygen (O2) on pediatric patients' apnea status and oxyhemoglobin saturation during: 1) conscious sedation for dental procedures and 2) the recovery period following sedation.
Methods:
Fourteen child patients (mean age 42 months) sedated with 50 mg/Kg chloral hydrate, 25 mg hydroxyzine pamoate, and 1.5 mg/Kg meperidine were treated for two separate appointments. The patients received supplemental O2 via nasal cannulae at random at one of the two appointments. Following the operative period, all patients were monitored sitting upright for an additional 15 min.
Results:
Intraoperative results showed that the risk of apnea was 39% (11/28), with apneic events distributed equally between O2 and non-O2 supplemented sedations. The overall risk of desaturation was 29% (8/28). Mean SpO2 was always elevated with O2 supplementation and the mean difference in O2 versus non-O2 was statistically significant. The risk of apnea in the postoperative period was 7% (1/14) for both the non-O2 and O2-supplemented patients. The risk of desaturation in the postoperative period was 11% (3/28) with one desaturation in a non-O2 and two desaturations in O2-supplemented patients.
Conclusion:
We conclude that intraoperative O2 supplementation prevents desaturations even in the presence of apnea during pediatric conscious sedation.