Assessment of Alteration in Capnometry Monitoring during Intravenous Sedation with Midazolam for Oral Surgical Procedures.

Introduction: Capnography is routinely used for monitoring of patients subjected to sedation for different surgical procedures. There is still paucity of data highlighting the capnographic assessment of patients on midazolam sedation undergoing oral surgical procedures. Hence, we planned the present study to assess the alterations occurring in the end-tidal carbon dioxide (ETCO) values monitored during intravenous (IV) sedation with midazolam during various oral surgical procedures.

Materials And Methods: The present study included assessment of alteration in ETCO values occurring during oral surgical procedure. After meeting the inclusion and exclusion criteria, a total of 40 participants were included in the present study. Pulse oximeter with capnograph (EmcoMeditek Pvt., Ltd., India) device was used for assessment of respiratory rate (RR) and ETCO values. The mean of 12 readings over a period of 1 minute before the starting of first infusion was referred to as baseline time. By evaluating the first four readings at an interval of 15 seconds during the 1st minute of infusion, we obtained the 1 minute average reading. All the data were compiled and recorded and assessed by the Statistical Package for the Social Sciences (SPSS) software.

Results: A total of 40 participants were included, out of which, 20 were males and 20 were females. At the baseline time, mean value of ETCO was 31 mm Hg, while mean value of oxygen saturation (SpO) was 36%. Out of total 40 participants, 15 showed the presence of respiratory depression. Out of these 15 participants, ETCO changes from baseline were observed in 13 participants.

Conclusion: No oxygen should be delivered, unless until required, to the healthy participants undergoing dental sedation procedures, for marinating the sensitivity of pulse oximetry during assessment of respiratory depression.

Clinical Significance: In patients undergoing sedation procedures, various monitoring techniques should be employed as respiratory depression is a commonly encountered risk factor.