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A randomised controlled trial to determine if the addition of capnography to standard monitoring results in a decreased incidence of hypoxaemia during conscious sedation for oral surgery
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Date
2017
Authors
Brady, Paul
Journal Title
Journal ISSN
Volume Title
Publisher
University College Cork
Published Version
Abstract
Background: Data from procedural sedation suggest that capnography is a more sensitive measure of ventilation than standard modalities and detects respiratory depression before hypoxaemia occurs. However, the generalisability of published research is problematic. To date, 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 in a dental setting would decrease the incidence of hypoxaemia. Methods: A randomised controlled trial was conducted in which all patients (ASA I & II with BMI < 35 kg/m2) 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 defined as a fall in oxygen saturation (SpO2) ≤ 94%. Results: 190 patients, mean age 31.3 years (range 14–62 years) were enrolled. 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 (SD 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=0.5149, OR=0.78, 95% CI: 0.38–1.63). Conclusions: We were unable to confirm an additive role for capnography to prevent hypoxaemia during conscious sedation with Midazolam in a dental setting for patients not routinely administered supplemental oxygen. Clinical trial registration: ClinicalTrials.gov NCT01949012.
Description
Keywords
Capnography , Hypoxaemia , Conscious sedation
Citation
Brady, P. 2017. A randomised controlled trial to determine if the addition of capnography to standard monitoring results in a decreased incidence of hypoxaemia during conscious sedation for oral surgery. PhD Thesis, University College Cork.