Complications of Intravenous Midazolam-Fentanyl Sedation in Children and Adults Undergoing Oral Surgery: A Retrospective Study.

This study examines the incidence and predictors of complications following intravenous (IV) sedation in children and adults. A retrospective analysis of 1463 surgical procedures under IV sedation was conducted at the University Hospitals of Leuven (2018-2022). Patients aged 10-91 years were divided into pediatric (10-16 years, = 731) and adult (17-91 years, = 732) groups. Data were analyzed using multiple regression models ( < 0.05). Side effects occurred more often during recovery (children: 20.1%, adults: 9.4%) than intraoperatively (children: 4.8%, adults: 2.7%). The most common side effects were nausea (children: 10.5%, adults: 8.4%) and prolonged sedation (children: 6.0%, adults: 1.8%). Younger children had higher risks of intraoperative side effects ( = 0.02), hypotension ( < 0.001), and longer recovery ( < 0.001). Ketamine increased nausea risk in children ( = 0.02). Females had a higher risk of prolonged sedation ( = 0.03) and nausea ( = 0.01). Older adults had fewer recovery-related side effects ( = 0.03) and shorter recovery times ( = 0.05). IV sedation is a safe alternative to general anesthesia in oral surgery when properly monitored. However, nausea and prolonged sedation remain concerns, particularly in younger children and females. Prophylactic anti-emetics and cautious Ketamine use may help mitigate risks.