(1) Complications Resulting From Moderate and Deep Sedation in a Busy Academic Center: A Retrospective Analysis of Oral and Maxillofacial Surgery Attending- and Resident-Administered Procedural Sedation

Abstract: The purpose of this report is to analyze a dataset containing complications following moderate/deep intravenous sedation in oral and maxillofacial clinics associated with the University of Alabama Birmingham Medical Center. This analysis aims to provide insight toward the safety of sedation across locations and providers performing sedation. Recent controversy exists over office-based anesthesia in oral and maxillofacial surgery. This study evaluated complications of both attending administered intravenous sedation as well as attending supervised, resident-administered intravenous sedation at a busy academic oral surgery training program. This study examined both adult and pediatric intravenous sedation.

This is a retrospective cohort study of 3,940 patients receiving intravenous sedation for outpatient oral procedures at the University of Alabama Birmingham oral surgery clinic from 2012 to 2020. Demographic data, medications, and procedure duration were collected. The primary outcome was anesthesia-related adverse events.

Descriptive statistics were reported as counts and frequencies for categorical variables and mean, standard, deviation, range, and interquartile range for continuous variables. All analyses were conducted using SAS 9.4. There were 3 total adverse events (0.08% of cases). The complications were apnea, bradycardia, and nausea/vomiting. No permanent injuries or deaths occurred. No variables were associated with increased complications.

Intravenous sedation administered by both oral surgery attending doctors and residents under attending supervision was safe in an ambulatory training clinic, with a 0.08% complication rate comparable to established benchmarks. Outcomes support the safety of a supervised trainee model for anesthesia administration in oral and maxillofacial surgery training programs

References

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3. White Paper: Office-based Anesthesia provided by the Oral and Maxillofacial Surgeon. American Association of Oral and Maxillofacial Surgeons, 2016, pp 1–5, https://www.aaoms.org/docs/govt_affairs/advocacy_white_papers/advocacy_office_based_a nesthesia_whitepaper.pdf