Capnography monitoring in procedural intravenous sedation: a systematic review and meta-analysis
Objectives Currently, procedural sedation in the clinical setting relies heavily on the use of pulse oximetry to monitor hypoxemia. Different studies suggest that incidence of hypoxemia and incidence of arterial oxygen desaturation are reduced by early intervention via capnography monitoring. The ai...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Askar, Houssam [verfasserIn] Misch, Jonathan [verfasserIn] Chen, Zhaozhao [verfasserIn] Chadha, Sagar [verfasserIn] Wang, Hom-Lay [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2020 |
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| Übergeordnetes Werk: |
Enthalten in: Clinical Oral Investigations - Springer-Verlag, 2001, 24(2020), 11 vom: 16. Juni, Seite 3761-3770 |
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| Übergeordnetes Werk: |
volume:24 ; year:2020 ; number:11 ; day:16 ; month:06 ; pages:3761-3770 |
| Links: |
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| DOI / URN: |
10.1007/s00784-020-03395-1 |
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SPR041253825 |
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| 520 | |a Objectives Currently, procedural sedation in the clinical setting relies heavily on the use of pulse oximetry to monitor hypoxemia. Different studies suggest that incidence of hypoxemia and incidence of arterial oxygen desaturation are reduced by early intervention via capnography monitoring. The aim of this article was to discuss the importance of implementing capnography monitoring during procedural sedations performed in a dental setting and determine whether additional capnographic monitoring reduces the incidence of arterial oxygen desaturation and the overall complications rate. Materials and methods Two independent reviewers conducted electronic (PubMed and EMBASE) and manual searches up to February 2020. Randomized clinical trials (RCTs), including both patients under procedural sedation monitored by capnography and oximetry, and reporting the incidence of hypoxemia or episodes of oxygen desaturation were included. Risk ratio was used to compare the outcomes (i.e., the incidence of hypoxemia, the episodes of oxygen desaturation, the detection of apnea, the reduction of events of bradycardia, and hypotension) between patients monitored by capnography and standard approach. Results Fourteen randomized clinical trials fulfilling the inclusion criteria were selected. The analysis revealed that capnography monitoring group showed the lower incidence of hypoxemia (RR 0.76, 95%CI 0.70 to 0.83, p < 0.001) and the episodes of oxygen desaturation (RR 0.79, 95%CI 0.71 to 0.87, p < 0.001) compared with the oximetry monitoring group. Apnea was detected in capnography monitoring earlier than standard monitoring (RR 2.60, 95%CI 2.30 to 2.93, p < 0.001). No significant difference was found between capnography and standard monitoring groups in terms of reduction of events of bradycardia (RR 1.17, 95%CI 0.91 to 1.50, p = 0.225) and hypotension (RR 0.96, 95%CI 0.76 to 1.21, p = 0.746). Conclusion Capnography monitoring reduced incidence of hypoxemia during procedural sedations. Within the limitations of this review, we suggest that the application of capnography during procedural sedation would decrease the frequency of oxygen desaturation events and incidence of hypoxemia. Clinical relevance Training and instructing dental providers on using capnography monitoring would help in reducing adverse events during intravenous sedation. | ||
| 650 | 4 | |a Evidence based dentistry |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Intravenous sedation |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Procedural sedation |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Oral surgery |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Misch, Jonathan |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Zhaozhao |e verfasserin |4 aut | |
| 700 | 1 | |a Chadha, Sagar |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Hom-Lay |e verfasserin |4 aut | |
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10.1007/s00784-020-03395-1 doi (DE-627)SPR041253825 (SPR)s00784-020-03395-1-e DE-627 ger DE-627 rakwb eng Askar, Houssam verfasserin aut Capnography monitoring in procedural intravenous sedation: a systematic review and meta-analysis 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objectives Currently, procedural sedation in the clinical setting relies heavily on the use of pulse oximetry to monitor hypoxemia. Different studies suggest that incidence of hypoxemia and incidence of arterial oxygen desaturation are reduced by early intervention via capnography monitoring. The aim of this article was to discuss the importance of implementing capnography monitoring during procedural sedations performed in a dental setting and determine whether additional capnographic monitoring reduces the incidence of arterial oxygen desaturation and the overall complications rate. Materials and methods Two independent reviewers conducted electronic (PubMed and EMBASE) and manual searches up to February 2020. Randomized clinical trials (RCTs), including both patients under procedural sedation monitored by capnography and oximetry, and reporting the incidence of hypoxemia or episodes of oxygen desaturation were included. Risk ratio was used to compare the outcomes (i.e., the incidence of hypoxemia, the episodes of oxygen desaturation, the detection of apnea, the reduction of events of bradycardia, and hypotension) between patients monitored by capnography and standard approach. Results Fourteen randomized clinical trials fulfilling the inclusion criteria were selected. The analysis revealed that capnography monitoring group showed the lower incidence of hypoxemia (RR 0.76, 95%CI 0.70 to 0.83, p < 0.001) and the episodes of oxygen desaturation (RR 0.79, 95%CI 0.71 to 0.87, p < 0.001) compared with the oximetry monitoring group. Apnea was detected in capnography monitoring earlier than standard monitoring (RR 2.60, 95%CI 2.30 to 2.93, p < 0.001). No significant difference was found between capnography and standard monitoring groups in terms of reduction of events of bradycardia (RR 1.17, 95%CI 0.91 to 1.50, p = 0.225) and hypotension (RR 0.96, 95%CI 0.76 to 1.21, p = 0.746). Conclusion Capnography monitoring reduced incidence of hypoxemia during procedural sedations. Within the limitations of this review, we suggest that the application of capnography during procedural sedation would decrease the frequency of oxygen desaturation events and incidence of hypoxemia. Clinical relevance Training and instructing dental providers on using capnography monitoring would help in reducing adverse events during intravenous sedation. Evidence based dentistry (dpeaa)DE-He213 Intravenous sedation (dpeaa)DE-He213 Procedural sedation (dpeaa)DE-He213 Oral surgery (dpeaa)DE-He213 Misch, Jonathan verfasserin aut Chen, Zhaozhao verfasserin aut Chadha, Sagar verfasserin aut Wang, Hom-Lay verfasserin aut Enthalten in Clinical Oral Investigations Springer-Verlag, 2001 24(2020), 11 vom: 16. Juni, Seite 3761-3770 (DE-627)SPR007794231 nnns volume:24 year:2020 number:11 day:16 month:06 pages:3761-3770 https://dx.doi.org/10.1007/s00784-020-03395-1 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 24 2020 11 16 06 3761-3770 |
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10.1007/s00784-020-03395-1 doi (DE-627)SPR041253825 (SPR)s00784-020-03395-1-e DE-627 ger DE-627 rakwb eng Askar, Houssam verfasserin aut Capnography monitoring in procedural intravenous sedation: a systematic review and meta-analysis 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objectives Currently, procedural sedation in the clinical setting relies heavily on the use of pulse oximetry to monitor hypoxemia. Different studies suggest that incidence of hypoxemia and incidence of arterial oxygen desaturation are reduced by early intervention via capnography monitoring. The aim of this article was to discuss the importance of implementing capnography monitoring during procedural sedations performed in a dental setting and determine whether additional capnographic monitoring reduces the incidence of arterial oxygen desaturation and the overall complications rate. Materials and methods Two independent reviewers conducted electronic (PubMed and EMBASE) and manual searches up to February 2020. Randomized clinical trials (RCTs), including both patients under procedural sedation monitored by capnography and oximetry, and reporting the incidence of hypoxemia or episodes of oxygen desaturation were included. Risk ratio was used to compare the outcomes (i.e., the incidence of hypoxemia, the episodes of oxygen desaturation, the detection of apnea, the reduction of events of bradycardia, and hypotension) between patients monitored by capnography and standard approach. Results Fourteen randomized clinical trials fulfilling the inclusion criteria were selected. The analysis revealed that capnography monitoring group showed the lower incidence of hypoxemia (RR 0.76, 95%CI 0.70 to 0.83, p < 0.001) and the episodes of oxygen desaturation (RR 0.79, 95%CI 0.71 to 0.87, p < 0.001) compared with the oximetry monitoring group. Apnea was detected in capnography monitoring earlier than standard monitoring (RR 2.60, 95%CI 2.30 to 2.93, p < 0.001). No significant difference was found between capnography and standard monitoring groups in terms of reduction of events of bradycardia (RR 1.17, 95%CI 0.91 to 1.50, p = 0.225) and hypotension (RR 0.96, 95%CI 0.76 to 1.21, p = 0.746). Conclusion Capnography monitoring reduced incidence of hypoxemia during procedural sedations. Within the limitations of this review, we suggest that the application of capnography during procedural sedation would decrease the frequency of oxygen desaturation events and incidence of hypoxemia. Clinical relevance Training and instructing dental providers on using capnography monitoring would help in reducing adverse events during intravenous sedation. Evidence based dentistry (dpeaa)DE-He213 Intravenous sedation (dpeaa)DE-He213 Procedural sedation (dpeaa)DE-He213 Oral surgery (dpeaa)DE-He213 Misch, Jonathan verfasserin aut Chen, Zhaozhao verfasserin aut Chadha, Sagar verfasserin aut Wang, Hom-Lay verfasserin aut Enthalten in Clinical Oral Investigations Springer-Verlag, 2001 24(2020), 11 vom: 16. Juni, Seite 3761-3770 (DE-627)SPR007794231 nnns volume:24 year:2020 number:11 day:16 month:06 pages:3761-3770 https://dx.doi.org/10.1007/s00784-020-03395-1 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 24 2020 11 16 06 3761-3770 |
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10.1007/s00784-020-03395-1 doi (DE-627)SPR041253825 (SPR)s00784-020-03395-1-e DE-627 ger DE-627 rakwb eng Askar, Houssam verfasserin aut Capnography monitoring in procedural intravenous sedation: a systematic review and meta-analysis 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objectives Currently, procedural sedation in the clinical setting relies heavily on the use of pulse oximetry to monitor hypoxemia. Different studies suggest that incidence of hypoxemia and incidence of arterial oxygen desaturation are reduced by early intervention via capnography monitoring. The aim of this article was to discuss the importance of implementing capnography monitoring during procedural sedations performed in a dental setting and determine whether additional capnographic monitoring reduces the incidence of arterial oxygen desaturation and the overall complications rate. Materials and methods Two independent reviewers conducted electronic (PubMed and EMBASE) and manual searches up to February 2020. Randomized clinical trials (RCTs), including both patients under procedural sedation monitored by capnography and oximetry, and reporting the incidence of hypoxemia or episodes of oxygen desaturation were included. Risk ratio was used to compare the outcomes (i.e., the incidence of hypoxemia, the episodes of oxygen desaturation, the detection of apnea, the reduction of events of bradycardia, and hypotension) between patients monitored by capnography and standard approach. Results Fourteen randomized clinical trials fulfilling the inclusion criteria were selected. The analysis revealed that capnography monitoring group showed the lower incidence of hypoxemia (RR 0.76, 95%CI 0.70 to 0.83, p < 0.001) and the episodes of oxygen desaturation (RR 0.79, 95%CI 0.71 to 0.87, p < 0.001) compared with the oximetry monitoring group. Apnea was detected in capnography monitoring earlier than standard monitoring (RR 2.60, 95%CI 2.30 to 2.93, p < 0.001). No significant difference was found between capnography and standard monitoring groups in terms of reduction of events of bradycardia (RR 1.17, 95%CI 0.91 to 1.50, p = 0.225) and hypotension (RR 0.96, 95%CI 0.76 to 1.21, p = 0.746). Conclusion Capnography monitoring reduced incidence of hypoxemia during procedural sedations. Within the limitations of this review, we suggest that the application of capnography during procedural sedation would decrease the frequency of oxygen desaturation events and incidence of hypoxemia. Clinical relevance Training and instructing dental providers on using capnography monitoring would help in reducing adverse events during intravenous sedation. Evidence based dentistry (dpeaa)DE-He213 Intravenous sedation (dpeaa)DE-He213 Procedural sedation (dpeaa)DE-He213 Oral surgery (dpeaa)DE-He213 Misch, Jonathan verfasserin aut Chen, Zhaozhao verfasserin aut Chadha, Sagar verfasserin aut Wang, Hom-Lay verfasserin aut Enthalten in Clinical Oral Investigations Springer-Verlag, 2001 24(2020), 11 vom: 16. Juni, Seite 3761-3770 (DE-627)SPR007794231 nnns volume:24 year:2020 number:11 day:16 month:06 pages:3761-3770 https://dx.doi.org/10.1007/s00784-020-03395-1 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 24 2020 11 16 06 3761-3770 |
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10.1007/s00784-020-03395-1 doi (DE-627)SPR041253825 (SPR)s00784-020-03395-1-e DE-627 ger DE-627 rakwb eng Askar, Houssam verfasserin aut Capnography monitoring in procedural intravenous sedation: a systematic review and meta-analysis 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objectives Currently, procedural sedation in the clinical setting relies heavily on the use of pulse oximetry to monitor hypoxemia. Different studies suggest that incidence of hypoxemia and incidence of arterial oxygen desaturation are reduced by early intervention via capnography monitoring. The aim of this article was to discuss the importance of implementing capnography monitoring during procedural sedations performed in a dental setting and determine whether additional capnographic monitoring reduces the incidence of arterial oxygen desaturation and the overall complications rate. Materials and methods Two independent reviewers conducted electronic (PubMed and EMBASE) and manual searches up to February 2020. Randomized clinical trials (RCTs), including both patients under procedural sedation monitored by capnography and oximetry, and reporting the incidence of hypoxemia or episodes of oxygen desaturation were included. Risk ratio was used to compare the outcomes (i.e., the incidence of hypoxemia, the episodes of oxygen desaturation, the detection of apnea, the reduction of events of bradycardia, and hypotension) between patients monitored by capnography and standard approach. Results Fourteen randomized clinical trials fulfilling the inclusion criteria were selected. The analysis revealed that capnography monitoring group showed the lower incidence of hypoxemia (RR 0.76, 95%CI 0.70 to 0.83, p < 0.001) and the episodes of oxygen desaturation (RR 0.79, 95%CI 0.71 to 0.87, p < 0.001) compared with the oximetry monitoring group. Apnea was detected in capnography monitoring earlier than standard monitoring (RR 2.60, 95%CI 2.30 to 2.93, p < 0.001). No significant difference was found between capnography and standard monitoring groups in terms of reduction of events of bradycardia (RR 1.17, 95%CI 0.91 to 1.50, p = 0.225) and hypotension (RR 0.96, 95%CI 0.76 to 1.21, p = 0.746). Conclusion Capnography monitoring reduced incidence of hypoxemia during procedural sedations. Within the limitations of this review, we suggest that the application of capnography during procedural sedation would decrease the frequency of oxygen desaturation events and incidence of hypoxemia. Clinical relevance Training and instructing dental providers on using capnography monitoring would help in reducing adverse events during intravenous sedation. Evidence based dentistry (dpeaa)DE-He213 Intravenous sedation (dpeaa)DE-He213 Procedural sedation (dpeaa)DE-He213 Oral surgery (dpeaa)DE-He213 Misch, Jonathan verfasserin aut Chen, Zhaozhao verfasserin aut Chadha, Sagar verfasserin aut Wang, Hom-Lay verfasserin aut Enthalten in Clinical Oral Investigations Springer-Verlag, 2001 24(2020), 11 vom: 16. Juni, Seite 3761-3770 (DE-627)SPR007794231 nnns volume:24 year:2020 number:11 day:16 month:06 pages:3761-3770 https://dx.doi.org/10.1007/s00784-020-03395-1 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 24 2020 11 16 06 3761-3770 |
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10.1007/s00784-020-03395-1 doi (DE-627)SPR041253825 (SPR)s00784-020-03395-1-e DE-627 ger DE-627 rakwb eng Askar, Houssam verfasserin aut Capnography monitoring in procedural intravenous sedation: a systematic review and meta-analysis 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objectives Currently, procedural sedation in the clinical setting relies heavily on the use of pulse oximetry to monitor hypoxemia. Different studies suggest that incidence of hypoxemia and incidence of arterial oxygen desaturation are reduced by early intervention via capnography monitoring. The aim of this article was to discuss the importance of implementing capnography monitoring during procedural sedations performed in a dental setting and determine whether additional capnographic monitoring reduces the incidence of arterial oxygen desaturation and the overall complications rate. Materials and methods Two independent reviewers conducted electronic (PubMed and EMBASE) and manual searches up to February 2020. Randomized clinical trials (RCTs), including both patients under procedural sedation monitored by capnography and oximetry, and reporting the incidence of hypoxemia or episodes of oxygen desaturation were included. Risk ratio was used to compare the outcomes (i.e., the incidence of hypoxemia, the episodes of oxygen desaturation, the detection of apnea, the reduction of events of bradycardia, and hypotension) between patients monitored by capnography and standard approach. Results Fourteen randomized clinical trials fulfilling the inclusion criteria were selected. The analysis revealed that capnography monitoring group showed the lower incidence of hypoxemia (RR 0.76, 95%CI 0.70 to 0.83, p < 0.001) and the episodes of oxygen desaturation (RR 0.79, 95%CI 0.71 to 0.87, p < 0.001) compared with the oximetry monitoring group. Apnea was detected in capnography monitoring earlier than standard monitoring (RR 2.60, 95%CI 2.30 to 2.93, p < 0.001). No significant difference was found between capnography and standard monitoring groups in terms of reduction of events of bradycardia (RR 1.17, 95%CI 0.91 to 1.50, p = 0.225) and hypotension (RR 0.96, 95%CI 0.76 to 1.21, p = 0.746). Conclusion Capnography monitoring reduced incidence of hypoxemia during procedural sedations. Within the limitations of this review, we suggest that the application of capnography during procedural sedation would decrease the frequency of oxygen desaturation events and incidence of hypoxemia. Clinical relevance Training and instructing dental providers on using capnography monitoring would help in reducing adverse events during intravenous sedation. Evidence based dentistry (dpeaa)DE-He213 Intravenous sedation (dpeaa)DE-He213 Procedural sedation (dpeaa)DE-He213 Oral surgery (dpeaa)DE-He213 Misch, Jonathan verfasserin aut Chen, Zhaozhao verfasserin aut Chadha, Sagar verfasserin aut Wang, Hom-Lay verfasserin aut Enthalten in Clinical Oral Investigations Springer-Verlag, 2001 24(2020), 11 vom: 16. Juni, Seite 3761-3770 (DE-627)SPR007794231 nnns volume:24 year:2020 number:11 day:16 month:06 pages:3761-3770 https://dx.doi.org/10.1007/s00784-020-03395-1 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 24 2020 11 16 06 3761-3770 |
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Different studies suggest that incidence of hypoxemia and incidence of arterial oxygen desaturation are reduced by early intervention via capnography monitoring. The aim of this article was to discuss the importance of implementing capnography monitoring during procedural sedations performed in a dental setting and determine whether additional capnographic monitoring reduces the incidence of arterial oxygen desaturation and the overall complications rate. Materials and methods Two independent reviewers conducted electronic (PubMed and EMBASE) and manual searches up to February 2020. Randomized clinical trials (RCTs), including both patients under procedural sedation monitored by capnography and oximetry, and reporting the incidence of hypoxemia or episodes of oxygen desaturation were included. Risk ratio was used to compare the outcomes (i.e., the incidence of hypoxemia, the episodes of oxygen desaturation, the detection of apnea, the reduction of events of bradycardia, and hypotension) between patients monitored by capnography and standard approach. Results Fourteen randomized clinical trials fulfilling the inclusion criteria were selected. The analysis revealed that capnography monitoring group showed the lower incidence of hypoxemia (RR 0.76, 95%CI 0.70 to 0.83, p < 0.001) and the episodes of oxygen desaturation (RR 0.79, 95%CI 0.71 to 0.87, p < 0.001) compared with the oximetry monitoring group. Apnea was detected in capnography monitoring earlier than standard monitoring (RR 2.60, 95%CI 2.30 to 2.93, p < 0.001). No significant difference was found between capnography and standard monitoring groups in terms of reduction of events of bradycardia (RR 1.17, 95%CI 0.91 to 1.50, p = 0.225) and hypotension (RR 0.96, 95%CI 0.76 to 1.21, p = 0.746). Conclusion Capnography monitoring reduced incidence of hypoxemia during procedural sedations. Within the limitations of this review, we suggest that the application of capnography during procedural sedation would decrease the frequency of oxygen desaturation events and incidence of hypoxemia. 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Capnography monitoring in procedural intravenous sedation: a systematic review and meta-analysis Evidence based dentistry (dpeaa)DE-He213 Intravenous sedation (dpeaa)DE-He213 Procedural sedation (dpeaa)DE-He213 Oral surgery (dpeaa)DE-He213 |
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capnography monitoring in procedural intravenous sedation: a systematic review and meta-analysis |
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Capnography monitoring in procedural intravenous sedation: a systematic review and meta-analysis |
| abstract |
Objectives Currently, procedural sedation in the clinical setting relies heavily on the use of pulse oximetry to monitor hypoxemia. Different studies suggest that incidence of hypoxemia and incidence of arterial oxygen desaturation are reduced by early intervention via capnography monitoring. The aim of this article was to discuss the importance of implementing capnography monitoring during procedural sedations performed in a dental setting and determine whether additional capnographic monitoring reduces the incidence of arterial oxygen desaturation and the overall complications rate. Materials and methods Two independent reviewers conducted electronic (PubMed and EMBASE) and manual searches up to February 2020. Randomized clinical trials (RCTs), including both patients under procedural sedation monitored by capnography and oximetry, and reporting the incidence of hypoxemia or episodes of oxygen desaturation were included. Risk ratio was used to compare the outcomes (i.e., the incidence of hypoxemia, the episodes of oxygen desaturation, the detection of apnea, the reduction of events of bradycardia, and hypotension) between patients monitored by capnography and standard approach. Results Fourteen randomized clinical trials fulfilling the inclusion criteria were selected. The analysis revealed that capnography monitoring group showed the lower incidence of hypoxemia (RR 0.76, 95%CI 0.70 to 0.83, p < 0.001) and the episodes of oxygen desaturation (RR 0.79, 95%CI 0.71 to 0.87, p < 0.001) compared with the oximetry monitoring group. Apnea was detected in capnography monitoring earlier than standard monitoring (RR 2.60, 95%CI 2.30 to 2.93, p < 0.001). No significant difference was found between capnography and standard monitoring groups in terms of reduction of events of bradycardia (RR 1.17, 95%CI 0.91 to 1.50, p = 0.225) and hypotension (RR 0.96, 95%CI 0.76 to 1.21, p = 0.746). Conclusion Capnography monitoring reduced incidence of hypoxemia during procedural sedations. Within the limitations of this review, we suggest that the application of capnography during procedural sedation would decrease the frequency of oxygen desaturation events and incidence of hypoxemia. Clinical relevance Training and instructing dental providers on using capnography monitoring would help in reducing adverse events during intravenous sedation. |
| abstractGer |
Objectives Currently, procedural sedation in the clinical setting relies heavily on the use of pulse oximetry to monitor hypoxemia. Different studies suggest that incidence of hypoxemia and incidence of arterial oxygen desaturation are reduced by early intervention via capnography monitoring. The aim of this article was to discuss the importance of implementing capnography monitoring during procedural sedations performed in a dental setting and determine whether additional capnographic monitoring reduces the incidence of arterial oxygen desaturation and the overall complications rate. Materials and methods Two independent reviewers conducted electronic (PubMed and EMBASE) and manual searches up to February 2020. Randomized clinical trials (RCTs), including both patients under procedural sedation monitored by capnography and oximetry, and reporting the incidence of hypoxemia or episodes of oxygen desaturation were included. Risk ratio was used to compare the outcomes (i.e., the incidence of hypoxemia, the episodes of oxygen desaturation, the detection of apnea, the reduction of events of bradycardia, and hypotension) between patients monitored by capnography and standard approach. Results Fourteen randomized clinical trials fulfilling the inclusion criteria were selected. The analysis revealed that capnography monitoring group showed the lower incidence of hypoxemia (RR 0.76, 95%CI 0.70 to 0.83, p < 0.001) and the episodes of oxygen desaturation (RR 0.79, 95%CI 0.71 to 0.87, p < 0.001) compared with the oximetry monitoring group. Apnea was detected in capnography monitoring earlier than standard monitoring (RR 2.60, 95%CI 2.30 to 2.93, p < 0.001). No significant difference was found between capnography and standard monitoring groups in terms of reduction of events of bradycardia (RR 1.17, 95%CI 0.91 to 1.50, p = 0.225) and hypotension (RR 0.96, 95%CI 0.76 to 1.21, p = 0.746). Conclusion Capnography monitoring reduced incidence of hypoxemia during procedural sedations. Within the limitations of this review, we suggest that the application of capnography during procedural sedation would decrease the frequency of oxygen desaturation events and incidence of hypoxemia. Clinical relevance Training and instructing dental providers on using capnography monitoring would help in reducing adverse events during intravenous sedation. |
| abstract_unstemmed |
Objectives Currently, procedural sedation in the clinical setting relies heavily on the use of pulse oximetry to monitor hypoxemia. Different studies suggest that incidence of hypoxemia and incidence of arterial oxygen desaturation are reduced by early intervention via capnography monitoring. The aim of this article was to discuss the importance of implementing capnography monitoring during procedural sedations performed in a dental setting and determine whether additional capnographic monitoring reduces the incidence of arterial oxygen desaturation and the overall complications rate. Materials and methods Two independent reviewers conducted electronic (PubMed and EMBASE) and manual searches up to February 2020. Randomized clinical trials (RCTs), including both patients under procedural sedation monitored by capnography and oximetry, and reporting the incidence of hypoxemia or episodes of oxygen desaturation were included. Risk ratio was used to compare the outcomes (i.e., the incidence of hypoxemia, the episodes of oxygen desaturation, the detection of apnea, the reduction of events of bradycardia, and hypotension) between patients monitored by capnography and standard approach. Results Fourteen randomized clinical trials fulfilling the inclusion criteria were selected. The analysis revealed that capnography monitoring group showed the lower incidence of hypoxemia (RR 0.76, 95%CI 0.70 to 0.83, p < 0.001) and the episodes of oxygen desaturation (RR 0.79, 95%CI 0.71 to 0.87, p < 0.001) compared with the oximetry monitoring group. Apnea was detected in capnography monitoring earlier than standard monitoring (RR 2.60, 95%CI 2.30 to 2.93, p < 0.001). No significant difference was found between capnography and standard monitoring groups in terms of reduction of events of bradycardia (RR 1.17, 95%CI 0.91 to 1.50, p = 0.225) and hypotension (RR 0.96, 95%CI 0.76 to 1.21, p = 0.746). Conclusion Capnography monitoring reduced incidence of hypoxemia during procedural sedations. Within the limitations of this review, we suggest that the application of capnography during procedural sedation would decrease the frequency of oxygen desaturation events and incidence of hypoxemia. Clinical relevance Training and instructing dental providers on using capnography monitoring would help in reducing adverse events during intravenous sedation. |
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