Problems associated with prolonged intravenous sedation management

Abstract

Cases with problems associated with intravenous sedation administered at the Nippon University School of Dentistry Hospital in Niigata from 1998 to 2002 were selected in order to examine and to evaluate how to cope with these problems.
1. The number of cases where intravenous sedation was administered in 1998 was 228 and has continued to increase thereafter.
2. The number of cases that required intravenous sedation for more than two hours accounted for 3.2% of all cases evaluated. Our findings revealed that the cases requiring more than two hours of intravenous sedation were associated with a higher incidences of systemic complications than the cases that required less than two hours of intravenous sedation.
3. The problems revealed for the cases that required intravenous sedation for more than two hours were due to the stress of lying still in the same position for many hours, wearing off of or withdrawal from local anesthetic effect, and dehydration due to insufficient fluid hydration.
From the above results, it is important to establish a patient management system that is based on the fundamental concepts and basis to offer safe and comfortable dental care to the patients where surgical time is to be considered in the management system. It is also important to create an environment where patients can express their views openly where the attending doctors should respond to them promptly and adequately.