Propofol by continuous intravenous infusion was used as an alternative to nitrous oxide/oxygen for conscious sedation in 19 patients undergoing out-patient dental treatment. Patients were either extremely anxious or mentally and/or physically handicapped. Propofol was administered by a syringe pump at an initial rate of 3 mg/kg/hour. During the procedure the infusion rate was adjusted to attain and maintain the desired level of conscious sedation. The mean time from starting the propofol infusion until reaching the required level of sedation was 11.5 (SD 3.5) minutes. The mean infusion rate was 3.6 (SD 0.65) mg/kg/hour. The average duration of the dental procedure was 55.9 (SD 18.8) minutes. Sedation was satisfactory in all but two patients. There were no side-effects. Recovery was rapid after stopping the infusion. It is concluded that propofol is an acceptable alternative to nitrous oxide/oxygen for conscious sedation in the dental surgery.
The influence of sedative doses of propofol or nitrous oxide on the electroencephalogram was studied in 11 mentally handicapped patients with treated epilepsy undergoing dental procedures. At one session, propofol was titrated to achieve conscious sedation. The mean (+/- SD) dose requirements were 5.5 +/- 1.1 mg.kg-1.h-1. In six patients, the electroencephalogram was unchanged during propofol administration. In three patients, there was a decrease in epileptic activity, and in two patients, paroxysmal discharges disappeared. At another session, nitrous oxide was administered by nasal mask. The mean (+/- SD) concentration of nitrous oxide needed was 43.6% +/- 4.8%. The electroencephalogram did not change in nine patients, whereas in two patients epileptic activity decreased. There were no clinical epileptoid or other adverse manifestations during any treatment or up to 48 h thereafter. The results of the present study suggest that propofol or nitrous oxide can be administered in subanesthetic doses for conscious sedation in mentally handicapped patients with treated epilepsy.
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