Safety of deep intravenous propofol sedation in the dental treatment of children in the outpatient department

BACKGROUND/PURPOSE: Intravenous sedation with propofol in the dental treatment offers an alternative to inhalation sedation or general anesthesia. The aim of this study was to evaluate the safety and identify risk factors for intraoperative complications. MATERIALS AND METHODS: Uncooperative children who could not complete dental treatment under non-pharmacological behavior management or mild-to-moderate sedation in the outpatient pediatric department were selected. Details and time of dental treatment; intraoperative vital signs data, including blood pressure, heart rate, respiratory rate, pulse oxygen saturation (SpO(2)), end-tidal carbon dioxide, and electrocardiogram; and incidence of intraoperative and postoperative complications were recorded. RESULTS: Overall, 344 children were selected, with 342 completing dental treatment. The dental treatment time was 20–155 (median, 85; interquartile range, 70–100) min. The number of treated teeth was at least 1 and at most 13 (median, 6; interquartile range, 5–8). Among 342 children, 35 (10.2%) had their treatment interrupted temporarily due to choking cough. No serious complications occurred; the incidence rate of minor complications was 47/342 (13.7%). Tachycardia was observed in 5/342 (1.5%) cases, oxygen desaturation (SpO(2) < 95%) in 18, and hypoxemia (SpO2 ≤ 90%) in 25. The treatment duration was significant longer in cases with than without complications (P < 0.05), and children coughing during treatment were more likely to have complications (P < 0.05). Postoperative restlessness occurred in six children, but there was no vomiting, aspiration, or respiratory obstruction. CONCLUSION: Decreased oxygen saturation is the most common complications. Cough during treatment and longer treatment duration were risk factors for complications.