Defining Over-Sedation: Literature Review and National Survey of Dental Hospitals Within the United Kingdom

SAAD Dig. 2016 Jan:32:28-33.

Abstract

Aims: To review the literature, to investigate whether there was aconsensus on what encompasses over-sedation, and to determine the guidance employed for the administration of flumazenil.

Methods: A literature search was performed following which a self-designed questionnaire was emailed to 14 sedation leads within UK Dental Hospitals.

Results: 10 documents in the literature review met the inclusion criteria. In their definitions of over-sedation, loss of consciousness and respiratory depression were the main terms used; but a variety of terms were also seen, indicating a lack of agreement. Fourteen dental institutes were contacted of which nine (64%) responded. Thirty-seven per cent of sedation leads who responded stated they were unaware of a definition for over-sedation. Seventy-seven percent stated that when flumazenil was used this was recorded in a drugs book, with a broad range of justifications given.

Conclusion: This study shows that there is a lack of uniformity both from clinicians and the literature, in what encompasses over-sedation. This makes formulating an accepted definition of over-sedation difficult. In order to ensure accurate reporting, monitoring and auditing of such events, a clear definition for over-sedation is required and can be used to provide clarity when flumazenil is to be administered.

Publication types

  • Review

MeSH terms

  • Antidotes / therapeutic use
  • Conscious Sedation / adverse effects*
  • Consensus
  • Drug Overdose
  • Flumazenil / therapeutic use
  • Humans
  • Hypnotics and Sedatives / adverse effects*
  • Hypnotics and Sedatives / supply & distribution
  • Practice Guidelines as Topic
  • United Kingdom

Substances

  • Antidotes
  • Hypnotics and Sedatives
  • Flumazenil