Office-Based Ambulatory Sedation—The Use of the Airway Protector System During Oral Surgery: A Prospective Audit of the First 100 Patients

Klein, Moti; Weksler, Natan; Weksler, Doron; Bodner, Lipa

doi:10.1016/j.joms.2007.12.047

« Previous Next »Journal of Oral and Maxillofacial Surgery
Volume 66, Issue 5 , Pages 858-863, May 2008

Office-Based Ambulatory Sedation—The Use of the Airway Protector System During Oral Surgery: A Prospective Audit of the First 100 Patients

Moti Klein, MD
- Director, General Intensive Care Unit, Division of Anesthesiology and Critical Care, Soroka Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.
- Address correspondence and reprint requests to Dr Klein: General Intensive Care Unit, Division of Anesthesiology, Soroka Medical Center, Ben-Gurion University of the Negev, Faculty of Health Sciences, Beer-Sheva, Israel 84101
Natan Weksler, MD
- Professor, Division of Anesthesiology and Critical Care, Soroka Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.
Doron Weksler, BMS, MMA
- Paramedic, Motorola Negev, Magen David Adom, Arad, Israel.
Lipa Bodner, DMD
- Professor and Chairman, Oral and Maxillofacial Surgery Unit, Soroka Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.

Purpose

To evaluate the efficacy of the “Airway Protector System” (APS), a simple homemade device used for airway control during office-based dental sedation.

Patients and Methods

A prospective audit was performed in 100 severely dental phobic patients submitted to dental treatment in a dentist office under propofol sedation.

Results

Sixty-eight females and 32 males were enrolled in this study. The mean age was 45 ± 7 years (range, 18 to 67 years). A clear airway was obtained in 94 patients. Partial airway obstruction was observed in 4 patients but manual lifting of the jaw was enough to free the partial obstruction and dental treatment was uneventfully conducted. In 2 patients, the APS had to be converted to formal nasotracheal intubation because jaw-lifting maneuvers did not adequately relieve a partial airway obstruction. Sore throat was reported in 56 patients. In 27 cases, the patients rated the complaint as severe. No patient required a chest x-ray after sedation, as there was no clinical evidence of any pulmonary complication including dyspnea, cough, or fever.

Conclusion

We suggest that the concomitant use of a homemade cuffed nasopharyngeal airway with continuous suction facilitates airway control during deep levels of office-based sedation for dental treatment in severely dental phobic patients.