Dr. Zouaidi is a graduate research assistant in the Diagnostic and Biomedical Sciences Department, at the School of Dentistry, University of Texas Health Science Center at Houston, Houston, Texas, USA.
Dr. Olson is a professor and chair of the Department of Pediatric Dentistry, at the School of Dentistry, University of Texas Health Science Center at Houston, Houston, Texas, USA.
Pediatr Dent. 2022 May 15;44(3):174-180.
The purpose of this study was to examine a university-based dental electronic health records (EHR) database to identify sedation-related adverse events (AEs) and assess patients' behavioral outcomes during routine pediatric dental sedations (PDSs) in a dental school clinic. A database was screened for patients younger than 18 years old who had received dental sedation in 2019. The qualifying EHRs were then accessed and sedations were reviewed for AEs, which were categorized using a 12-point classification system and the Tracking and Reporting Outcomes of Procedural Sedation Tool. Patient behaviors were assessed using provider progress notes and categorized as presence/ absence of agitation. A total of 690 sedations were reviewed, yielding 28 AEs. Emesis was the most common AE observed in 1.3 percent of sedations. Respiratory and cardiovascular AEs were observed in 0.7 percent and 0.6 percent of sedations, respectively. Agitation was identified in 47.5 percent of sedations, while 34.1 percent of agitations resulted in the documented suspension of dental treatment. Agitation was mainly observed for nitrous oxide and oral sedation resulting in one failed sedation out of five sedations for each method. Potentially serious adverse effects were identified during pediatric dental sedations, but their incidence was low. A significant proportion of the sedated children experienced agitation, resulting in some sedation failures. Such events need to be tracked and examined for risk assessment reduction and quality-of-care improvement.
本研究旨在检查一所大学的牙科电子健康记录 (EHR) 数据库，以确定与镇静相关的不良事件 (AE)，并评估牙科学校诊所中常规儿科牙科镇静 (PDS) 期间患者的行为结果。筛选了数据库中 2019 年接受过牙科镇静的年龄小于 18 岁的患者。然后访问符合条件的 EHR，并对镇静进行 AE 审查，使用 12 点分类系统和跟踪和报告程序镇静结果工具对 AE 进行分类。使用提供者进展记录评估患者行为，并分为存在/不存在激动。共审查了 690 次镇静，发现 28 次 AE。呕吐是镇静中观察到的最常见 AE，占 1.3%。呼吸和心血管 AE 分别占镇静的 0.7%和 0.6%。躁动在 47.5%的镇静中被识别，而 34.1%的躁动导致记录暂停牙科治疗。躁动主要发生在笑气和口服镇静中，每种方法中有五分之一的镇静失败。在儿科牙科镇静期间发现了潜在的严重不良影响，但发生率较低。相当一部分接受镇静的儿童经历了躁动，导致一些镇静失败。需要对这些事件进行跟踪和检查，以降低风险评估并改善护理质量。
