Sedation
Kaitlyn Taylor, DDS
Pediatric Resident
University at Buffalo/Women and Children’s Hospital of Buffalo, Buffalo, NY
University at Buffalo/Women and Children’s Hospital of Buffalo, Buffalo, NY
Buffalo, New York, United States
Christopher Heard, MD
Pediatric Anesthesiologist
Oishei Children’s Hospital
Buffalo, New York, United States
Tammy Thompson, DDS
University at Buffalo
Buffalo, New York, United States
Christopher Heard, MD
Pediatric Anesthesiologist
Oishei Children’s Hospital
Buffalo, New York, United States
Purpose: The aim of this retrospective study is to compare the behavioral outcomes of sedation with respect to different types of sedation for pediatric and oral surgery patients.
Methods: The sedation records of pediatric and oral surgery (OS) patients were reviewed January through December 2021. Outcomes of sedation were graded using a behavior score; procedural completion, noise, and movement throughout procedure. This behavior score was used to compare the sedation outcome of pediatric patients undergoing oral (PO), intranasal (IN), and intravenous moderate sedation (MOD IV) and IV deep sedation pediatric (DEEP IV PED) and oral surgery (DEEP IV OS). A separate analysis was performed for patients with special needs (ADHD, ASD, DD) as well as psychotropic medication use.
Results: Overall 1233 charts were reviewed. The pediatric patients (n=803) ages ranged 2 to 19 years, OS patients (n=430) ages ranged 6 to 25 years. There were 44 patients with ASD and 65 with ADHD. The median behavior scores for PO, IN, MOD IV, DEEP IV PED, DEEP IV OS were:7.7, 7.2, 7.9, 9.4, 9.3 respectively. The average Midazolam dosing (mg/kg) for PO, IN, MOD IV, DEEP IV PED, DEEP IV OS were: 0.64, 0.46, 0.15, 0.13, 0.07 respectively. The airway intervention scores were lower (worse) the deeper the level of sedation the lower.
Conclusion: Increased depth of sedation improved behavior outcomes, however this results in increased risks for airway complications. Sedation for SN patients was equally effective for all sedation types.