Patient-maintained sedation for oral surgery using a target-controlled infusion of propofol - a pilot study

Objective To assess the safety and efficacy of a new patient-maintained propofol system for conscious sedation in dentistry. Design Prospective clinical trial. Setting Department of Sedation, Glasgow Dental Hospital and School, 2001. Subjects and methods Patients scheduled for oral surgery with conscious sedation. Exclusions included ASA IV -V, inability to use the handset, opioid use and severe respiratory disease. Interventions Patients were given intravenous propofol to a level of 1.0 mug/ml (reducing from 1.5 mug/ml) using a target controlled infusion system, they then controlled their sedation level by double-clicking a handset which on each activation increased the propofol concentration by 0.2 mug/ml. Main outcome measures Oxygen saturation, patient satisfaction, and surgeon satisfaction. Results Twenty patients were recruited, 16 female and four male. Nineteen patients completed sedation and treatment successfully. Mean lowest oxygen saturation was 94%. No patients were over-sedated. All patients successfully used the system to maintain a level of sedation adequate for their comfort. Patient and surgeon satisfaction were consistently high. Conclusions Initial experience with this novel system has confirmed safety, patient satisfaction and surgeon satisfaction.