Dental Sedation with Propofol-based Target Controlled Infusions: Changing Sedation Patterns and Our Current Approach after 2800 Office-based Procedures

Abstract

We describe the changing patterns of our office-based dental sedation technique over the past 5 years, based on the cumulative experience gained from treating 2800 patients. We also report the changing rate over time of minor, clinically insignificant adverse events based on a recent 652-patient audit of our office-based intravenous sedation (IVS). Our current preference, with most patients, is to administer a combination of propofol via a Target Controlled Infusion (TCI) in combination with TCI remifentanil. The rationale and reasons for this and the progressively changing doses of intravenous (IV) agents are discussed. Our office-based TCI IVS technique affords patient safety, high satisfaction rates and much faster discharge times in comparison with discharge times from mainstream hospitals. The surgeons are provided with greater scheduling flexibility plus the ability to operate in their own office with familiar staff.