Table 4. Summary of preoperative and intraoperative adverse events.
| First author/ Publication year | Age (month) | Sample size | Sedative drugs (mg/kg, %) | Administered by: / at: | Monitoring Equipment Information Interval (minute) | Results |
|---|---|---|---|---|---|---|
| Grissinger M 2019 [8] | 48 | 1 (1M) | Strapped onto the papoose board without proper head position | |||
| Death cause: improper position to protect his airway | ||||||
| Nordt SP 2014 [11] | 36 | 1 (1M) | CH (400) | Parents Home | Somnolent after 10 min, unresponsiveness | |
| Vomiting during ambulance | ||||||
| Esmolol infusion | ||||||
| Discharge after 30 h without sequelae | ||||||
| McCormack L 2014 [12] | 55 | 40 (21M, 19F) | CH (30), Mep (2), Hy (2), N2O-O2 (30-50) | Dentist | PO, PC, Visual observation | Mdz included regimen more body movement during treatment |
| Mdz (1), Mep (2), Hy (2), N2O-O2 (30-50) | Dental office | SaO2 | ||||
| Chicka MC 2012 [14] | 96 | 1 (1M) | CH (75), Hy (4.4) | Medical history of attention deficit disorder, on medication | ||
| 50 min after administration, stopped crying, turned blue, and no pulse when placed in papoose board | ||||||
| Remained in coma for 3 days | ||||||
| Hypoxic brain damage | ||||||
| 26.4 | 1 (1M) | Hydrocodone barbiturate, CH (25), Hy (5.8), Mep (4.6) | Mother Home | 2% lidocaine (13.2 mg/kg) | ||
| Patient turned blue, no breathing during treatment | ||||||
| Naloxone administration | ||||||
| Respiratory arrest, seizure | ||||||
| CPR by parent | ||||||
| Discharged satisfactory condition | ||||||
| Costa LR 2012 [15] | 43.2 | 42 (22M, 20F) | CH (70) | PO, BPC, Visual observation | 1 case (10%) in CH 70 mg/kg group had oxygen desaturation (SaO2 90%), irritation | |
| CH (100) | Dentist | |||||
| Mdz (1.0) | Dental office | HR, SaO2, BP, RR | ||||
| Mdz (1.5) | 15 | |||||
| de Rezende GP 2007 [17] | 35 | 1 (1M) | CH (100) | Dentist | HR, SaO2, BP, RR | Became active after 15 min |
| Dental office | Vomited twice during treatment | |||||
| 15 | Abdominal pain, thirst | |||||
| Observed aggressive behavior and fell asleep | ||||||
| Park MK 2006 [19] | 44.5 | 15 (6M, 9F) | CH (60), Hy (1), N2O-O2 (50) | Dentist | PO | No hypoxia, vomit, nausea |
| 34.3 | 16 (11M, 5F) | CH (60), Hy (1), Mdz (0.1), N2O-O2 (50) | Dental office | SaO2, PR | Mean SaO2: 99.1% | |
| 2 | No hypoxia, vomit, nausea | |||||
| Mean SaO2 : 98.6% | ||||||
| SaO2, 95% once | ||||||
| Myers GR 2004 [20] | 48.9 | 40 (22M, 18F) | CH (50), N2O-O2 (50) | PO, BPC, ECG, Capno, PC | 2 oxygen desaturation (SaO2 85%, 88%) cases, resolved with head positioning and mouth suctioning | |
| CH (50), Mdz (0.2), N2O-O2 (50) | HR, SaO2, BP, RR, ETCO2 | No desaturation | ||||
| 5 | ||||||
| Lee JH 2002 [21] | 42.2 | 40 (22M, 18F) | CH (60), Hy (25 mg) | Dentist | PO, PC | Mean SaO2: 98.1% |
| Dental office | PR, SaO2, RR | No true apnea | ||||
| 5 | True desaturation (SaO2 under 95%) 0–3 times per patient | |||||
| Leelatawe edwud P 2001 [22] | 47 | 111 (57M, 54F) | CH (50), Mep (1.5), Hy (25 mg), O2 (100) | Dentist Dental office | PO, PC, Visual observation, Capno | 2 true apnea cases (no visual sign of breathing, no breath sound, Capno 0 for 25 s) |
| PR, SaO2, BP, RR, ETCO2 | 3 prolonged sedation (need more than 30 min after treatment for discharge) cases | |||||
| 5 | 1 vomiting case | |||||
| Dallman JA 2001 [23] | 41.8 | 31 (23M, 8F) | Mdz (0.2), N2O-O2 (25-50) | Dentist | HR, SaO2, BP, RR | No vomit case |
| CH (62.5), PZ (12.5 mg), N2O-O2 (25-50) | Dental office | 5 | 1 vomiting case | |||
| Jung JH 2001 [24] | 30 | 71 (40M, 31F) | CH (60), Hy (25 mg) | Dentist | PO | Temporary hypoxia (SaO2 under 95%) 42.2% |
| Dental office | SaO2 | |||||
| Avalos-Arenas V 1998 [25] | 28.58 | 40 | CH (40), Hy (2), N2O-O2 (50) | Dentist | PO | At least 10% cases of hypoxia (SaO2 under 90%) |
| CH (40), Hy (2) | Dental office | HR, SaO2, BP, RR | ||||
| 15 | ||||||
| McCann W 1996 [27] | 45 | 40 (26M, 14F) | CH (40), Hy (2), N2O-O2 (50) | Dentist | PO | No desaturation (SaO2 under 95%) episodes |
| CH (40), Hy (2) | Dental office | HR, SaO2, BP, expired | ||||
| CO2 level | ||||||
| 5 | ||||||
| Needleman HL 1995 [28] | 31.2 | 382 (216M, 166F) | CH (55), Hy (1), N2O-O2 (40-60) | PO, PC | Intraoperative vomiting 8.1% | |
| HR, SaO2, RR | 21% of patients desaturation (SaO2 under 95%) | |||||
| 5 | ||||||
| Sams DR 1993 [31] | 31 | 24 | CH (50), PZ (1), N2O-O2 (< 50) | Dentist | HR, SaO2, BP, RR, | 2 desaturation (SaO2 90-95%) |
| 35.8 | Mep (1), N2O-O2 (< 50) | Dental office | Temp | |||
| 15 | ||||||
| Wilson S 1990 [30] | 28.8 | 12 | CH (40), Hy (2) | Dentist | PO, BPC, CO2 monitor, brain monitor | 13% true desaturation (SaO2 < 95%) |
| 30.1 | 10 | CH (25, 50, 70) | Dental office | HR, SaO2, BP, RR, expired CO2 level, EMG | 10% true desaturation (SaO2 under 95%) | |
| No significant difference between dosage of CH | ||||||
| Mueller WA 1985 [31] | 20 | CH (100), N2O-O2 (50) | Dentist | PO | 35% decreased SaO2 (SaO2 under 95%) | |
| Dental office | HR, BP, RR | |||||
| 5 |
CH, chloral hydrate; Hy, hydroxyzine; Mdz, midazolam; Mep, meperidine; PZ, promethazine; PO, pulse oximetry; PC, precordial stethoscope; SaO2, oxygen saturation; BPC, blood pressure cuff/sphygmomanometer; BP, blood pressure; HR, heart rate; RR, respiratory rate; PR, pulse rate; ECG, electrocardiography; Capno, capnography; ETCO2, end tidal carbon dioxide; EMG, electromyogram