Continuous transcutaneous O2 and CO2 monitoring during conscious sedation for oral surgery.

Forty-six American Society of Anesthesiologists Class I and II adults were randomly assigned to one to two study groups. Each subject received 0.7 microgram/kg of fentanyl and a titrated dose of midazolam. One group received 100% supplemental oxygen (O2) while another group received 50% nitrous oxide (N2O) and 50% O2. End-tidal carbon dioxide (EtCO2) and O2 saturation (SpO2) were measured at 5-min intervals throughout the procedure. We conclude that there was no significant difference in EtCO2 or O2 saturation between the two groups.

Effect of supplemental gases on end-tidal CO2 and oxygen saturation in patients undergoing fentanyl and midazolam outpatient sedation

Sixty patients undergoing third molar removal were used to evaluate the efficacy of supplemental oxygen administration when administered via nasal cannula or nasal mask. Arterial oxygen concentration was estimated by transcutaneous oxygen measurement. Both methods of oxygen administration resulted in increased levels of oxygen during surgery, with the nasal mask being more effective than the nasal cannula for raising oxygen levels. Intravenous premedication with the combination of diazepam and fentanyl resulted in less increase in oxygen levels. These findings suggest that oxygen supplementation during oral surgery with intravenous premedication is effective for maintaining adequate oxygenation.

Effect of supplemental oxygen on transcutaneous PO2 of patients undergoing surgical removal of third molars.

Fifty oral and maxillofacial surgery patients undergoing outpatient surgical removal of third molars under intravenous conscious sedation comprised the study group. All patients received 1 microgram/kg of fentanyl prior to receiving either diazepam or midazolam. The results show no statistically significant differences in blood pressure or pulse over time between the two groups, nor was there a statistically significant difference between the transcutaneous PO2 responses of the groups. However, a statistically significant time effect as well as a group by time interaction was present. Both groups show respiratory depression at the 8- and 10-minute time intervals. The use of supplemental oxygen and monitoring of respiration is recommended with the use of these drug combinations.

A comparison of transcutaneous PO2 in patients sedated with diazepam-fentanyl or midazolam-fentanyl.

Updating our concept of conscious sedation (amnesia-analgesia).

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Updating our concept of conscious sedation (amnesia-analgesia).