Microstream capnography during conscious sedation with midazolam for oral surgery: a randomised controlled trial,BDJ Open

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Microstream capnography during conscious sedation with midazolam for oral surgery: a randomised controlled trial
BDJ Open ( IF 2.5 ) Pub Date : 2017-10-13 , DOI: 10.1038/bdjopen.2017.19
Paul Brady ₁ , Gabriella Iohom ₂ , Ken D O'Halloran ₃ , Christine McCreary ₁ , Michael Cronin ₄

Affiliation

Objectives/Aims:

There has been no dentistry-specific published data supporting the use of monitoring with capnography for dental sedation. Our aim was to determine if adding capnography to standard monitoring during conscious sedation with midazolam would decrease the incidence of hypoxaemia.

Materials and Methods:

A randomised controlled trial was conducted in which all patients (ASA I and II) received standard monitoring and capnography, but were randomised to whether staff could view the capnography (intervention) or were blinded to it (control). The primary outcome was the incidence of hypoxaemia (SpO₂⩽94%).

Results:

We enrolled 190 patients, mean age 31 years (range, 14–62 years). There were 93 patients in the capnography group and 97 in the control group. The mean cumulative dose of midazolam titrated was 6.94 mg (s.d., 2.31; range, 3–20 mg). Six (3%) patients, three in each group, required temporary supplemental oxygen. There was no statistically significant difference between the capnography and control groups for the incidence of hypoxaemia: 34.4 vs 39.2% (P=0.4962, OR=0.81, 95% CI: 0.45–1.47).

Conclusions:

We were unable to confirm an additive role for capnography to prevent hypoxaemia during conscious sedation with midazolam for patients not routinely administered supplemental oxygen.

中文翻译：

咪达唑仑用于口腔手术的清醒镇静期间的微流二氧化碳图：一项随机对照试验

目标/目的：

没有牙科特定的已发表数据支持使用二氧化碳图监测进行牙科镇静。我们的目的是确定在使用咪达唑仑进行清醒镇静期间将二氧化碳图添加到标准监测中是否会降低低氧血症的发生率。

材料和方法：

进行了一项随机对照试验，其中所有患者（ASA I 和 II）都接受了标准监测和二氧化碳图，但随机分配给工作人员是否可以查看二氧化碳图（干预）或对其视而不见（对照）。主要结果是低氧血症的发生率（SpO ₂⩽ 94%）。

结果：

我们招募了 190 名患者，平均年龄 31 岁（范围 14-62 岁）。二氧化碳图组93例，对照组97例。滴定咪达唑仑的平均累积剂量为 6.94 mg（标准差，2.31；范围，3-20 mg）。六名（3%）患者，每组三名，需要临时补充氧气。二氧化碳图和对照组的低氧血症发生率无统计学差异：34.4% vs 39.2%（P =0.4962，OR=0.81，95% CI：0.45-1.47）。