As the number of children who are sedated for dental procedures has increased, the American Academy of Pediatrics (AAP) and the American Academy of Pediatric Dentistry (AAPD) have updated their recommendations to improve their safety.
The AAP and AAPD collaborated to unify recommendations used by medical and dental practitioners and to clarify and update previous reports. The new recommendations also include a new requirement to monitor expired carbon dioxide to ensure airway patency and gas exchanges. As a result, sedation monitoring is nearly identical to the requirements for general anesthesia.
Sedation for children is different from sedation for adults, as it is used to relieve pain and anxiety as well as to modify behavior. The potential for a life-threatening event such as apnea or airway obstruction requires a number of personnel to perform sedation and monitor the patient.
Children commonly pass from the intended level of sedation into a deeper, unintended level, according to the AAP and AAPD. The new guidelines, then, recommend having another provider in the procedure in addition to the practitioner to monitor the patient and assist in any supportive or resuscitation measures if needed.
The recommendations, “Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures: Update 2016,” will be published in the July 2016 issue of Pediatrics and in the July/August 2016 issue of Pediatric Dentistry. The AAP and AAPD also say that the monitoring and care outlined in this report may be exceeded at any time based on the practitioner’s judgment.