The safety of sedation for overweight/obese children in the dental setting

Pediatr Dent. 2012 Sep-Oct;34(5):392-6.

Abstract

Purpose: The goal of this study was to examine childhood overweight/obesity as a risk factor for adverse events during sedation for dental procedures.

Methods: This was a cross-sectional, retrospective, IRB-approved study that included 17 years of data (1992-2009). The outcome variables were desaturation, nausea/vomiting, prolonged sedation, and true apnea. The major explanatory variables were weight percentiles and BMI percentiles.

Results: A total of 510 patients met the inclusion criteria. Of these, 431 (86%) experienced no adverse events, 73 (14%) experienced one or more adverse events, and 6 had missing data. BMI data were available for a nested cohort of 103 children. Patients who experienced one or more adverse events had higher mean weights and BMI percentiles, though differences were not statistically significant. Another way to conceptualize the BMI data is to consider that 12% of the normal weight children experienced one or more adverse events versus 18% of the overweight/obese.

Conclusions: Overall, weight percentiles were higher in children who had one or more adverse events. Similarly, patients with higher BMI percentiles were more likely to experience adverse events. Although preliminary in nature, these findings suggest that childhood overweight/obesity may be associated with adverse events during sedation for dental procedures.

MeSH terms

  • Anesthesia Recovery Period
  • Anesthesia, Dental / adverse effects*
  • Anesthesia, Dental / methods
  • Apnea / etiology
  • Body Mass Index
  • Case-Control Studies
  • Chi-Square Distribution
  • Child
  • Child, Preschool
  • Chloral Hydrate / adverse effects*
  • Conscious Sedation / adverse effects*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hypnotics and Sedatives / adverse effects*
  • Hypoxia / etiology
  • Male
  • Overweight / complications*
  • Oxyhemoglobins / analysis
  • Patient Safety
  • Postoperative Nausea and Vomiting / etiology
  • Retrospective Studies

Substances

  • Hypnotics and Sedatives
  • Oxyhemoglobins
  • Chloral Hydrate