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Intravenous sedation for dental treatment in patients with intellectual disability-efficacy of nasal airway, pharyngeal suction tube and oxygen tube placement

Background/Purpose: We performed a comparison of the quality and safety of dental treatment under intravenous sedation in patients with moderate or severe intellectual disability using the conventional method (intravenous sedation: IVS group) and a method using a nasal airway, suction tube and oxygen tube placed into the pharynx (intravenous sedation with airway and suction tube: IVSAS group).

Materials and Methods: The medical records of 43 patients (72 cases) with moderate or severe intellectual disability who underwent dental treatment under intravenous sedation were retrospectively evaluated for patient characteristics, sedation time, amount of medication and quality of sedation. The level of sedation was assessed using the Ramsay Sedation Scale (RSS).

Results: Median patient age was 18 years (6 to 46 years). Comparison of the IVSAS and IVS groups indicated no significant differences in patient background. The median RSS score during treatment was 5 in the IVSAS group and 4 in the IVS group, suggesting no difference. In terms of the quality of sedation, cough reflex was observed in 40 cases, (22/50 cases in the IVSAS group, 18/22 cases in the IVS group), and 30 patients moved spontaneously (14/50, 16/22, respectively); the incidence of such events was lower in the IVSAS than IVS group.

Conclusions: In patients with moderate or severe intellectual disability, intravenous sedation (deep sedation) together with use of a nasal airway, suction tube and oxygen tube placed in the pharynx was considered to improve the quality and safety of sedation during dental treatment.

Author(s): Yoshinari Morimoto, Megumi Hayashi, Chizuko Yokoe, Tomoko Kinugawa, Takatoshi Iida, Aiji Boku, Aiko Ohyamaguchi, Hiroharu Maegawa, Kazuaki Yamagata