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Association between bispectral analysis and level of conscious sedation of pediatric dental patients.
Pediatr Dent 2002 May-Jun; 24(3):221-6PD

Abstract

PURPOSE

This preliminary investigation evaluated the associations among multiple factors designed to measure depth of sedation, such as changes in the patient's electroencephalogram (EEG) via a bispectral analysis (BIS), other physiological variables, observed behaviors and clinical assessment of sedation levels consistent with the American Academy of Pediatric Dentistry (AAPD) sedation guidelines.

METHODS

Thirty-four healthy pediatric patients between three to six years of age were enrolled in this institutionally approved study. All children required dental restorations and were uncooperative. The children received a routine oral sedation regimen used in our clinic consisting of chloral hydrate, meperidine, and hydroxyzine that varied in dose for each child. Intraoperatively, nitrous oxide/oxygen was also administered. Physiological variables including oxygen saturation, blood pressure and heart rate were recorded in compliance with AAPD sedation guidelines. The behavior and levels of sedation consistent with AAPD guidelines were also recorded. The BIS monitor was used to obtain EEG information.

RESULTS

Useful data were recorded from 21 patients. The mean age and weight of the children were 46.1 +/- 10 months and 16.1 +/- 5 kgs, respectively. The results show a significant association between observed patient behavior and the AAPD levels of sedation (chi2 = 105.1, df = 6, P< 0.0001), between levels of sedation and behavior as a function of 12 time-oriented periods during treatment, (chi2=41.90, df=22, P<0.005 and chi2=48.0, df=33, P=0.04, respectively) and between BIS readings as a function of both level of sedation and behavior (chi2=105.1, df=6, P<0.001 and chi2=28.5, df = 18, P< 0.05, respectively).

CONCLUSIONS

There appears to be a significant association between observed patient behaviors during sedation and levels of sedation as measured by BIS and AAPD sedation guidelines. The study also showed that, under treatment conditions used in this study, BIS does not appear to be a more valid means of monitoring sedation depth than the current commonly accepted methods.

Authors+Show Affiliations

Department of Dental Anesthesiology, The Ohio State University and Columbus Children 's Hospital, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

12064495

Citation

Religa, Zdzislaw Christopher, et al. "Association Between Bispectral Analysis and Level of Conscious Sedation of Pediatric Dental Patients." Pediatric Dentistry, vol. 24, no. 3, 2002, pp. 221-6.
Religa ZC, Wilson S, Ganzberg SI, et al. Association between bispectral analysis and level of conscious sedation of pediatric dental patients. Pediatr Dent. 2002;24(3):221-6.
Religa, Z. C., Wilson, S., Ganzberg, S. I., & Casamassimo, P. S. (2002). Association between bispectral analysis and level of conscious sedation of pediatric dental patients. Pediatric Dentistry, 24(3), pp. 221-6.
Religa ZC, et al. Association Between Bispectral Analysis and Level of Conscious Sedation of Pediatric Dental Patients. Pediatr Dent. 2002;24(3):221-6. PubMed PMID: 12064495.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association between bispectral analysis and level of conscious sedation of pediatric dental patients. AU - Religa,Zdzislaw Christopher, AU - Wilson,Stephen, AU - Ganzberg,Stephen I, AU - Casamassimo,Paul S, PY - 2002/6/18/pubmed PY - 2002/9/17/medline PY - 2002/6/18/entrez SP - 221 EP - 6 JF - Pediatric dentistry JO - Pediatr Dent VL - 24 IS - 3 N2 - PURPOSE: This preliminary investigation evaluated the associations among multiple factors designed to measure depth of sedation, such as changes in the patient's electroencephalogram (EEG) via a bispectral analysis (BIS), other physiological variables, observed behaviors and clinical assessment of sedation levels consistent with the American Academy of Pediatric Dentistry (AAPD) sedation guidelines. METHODS: Thirty-four healthy pediatric patients between three to six years of age were enrolled in this institutionally approved study. All children required dental restorations and were uncooperative. The children received a routine oral sedation regimen used in our clinic consisting of chloral hydrate, meperidine, and hydroxyzine that varied in dose for each child. Intraoperatively, nitrous oxide/oxygen was also administered. Physiological variables including oxygen saturation, blood pressure and heart rate were recorded in compliance with AAPD sedation guidelines. The behavior and levels of sedation consistent with AAPD guidelines were also recorded. The BIS monitor was used to obtain EEG information. RESULTS: Useful data were recorded from 21 patients. The mean age and weight of the children were 46.1 +/- 10 months and 16.1 +/- 5 kgs, respectively. The results show a significant association between observed patient behavior and the AAPD levels of sedation (chi2 = 105.1, df = 6, P< 0.0001), between levels of sedation and behavior as a function of 12 time-oriented periods during treatment, (chi2=41.90, df=22, P<0.005 and chi2=48.0, df=33, P=0.04, respectively) and between BIS readings as a function of both level of sedation and behavior (chi2=105.1, df=6, P<0.001 and chi2=28.5, df = 18, P< 0.05, respectively). CONCLUSIONS: There appears to be a significant association between observed patient behaviors during sedation and levels of sedation as measured by BIS and AAPD sedation guidelines. The study also showed that, under treatment conditions used in this study, BIS does not appear to be a more valid means of monitoring sedation depth than the current commonly accepted methods. SN - 0164-1263 UR - https://www.unboundmedicine.com/medline/citation/12064495/Association_between_bispectral_analysis_and_level_of_conscious_sedation_of_pediatric_dental_patients_ DB - PRIME DP - Unbound Medicine ER -