{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T01:13:22Z","timestamp":1789866802063,"version":"4.0.1"},"reference-count":24,"publisher":"American Dental Society of Anesthesiology (ADSA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013]]},"abstract":"<jats:title>Abstract<\/jats:title>\n        <jats:p>The purpose of this study was to identify the risk factors associated with low peripheral oxygen saturation (SpO<jats:sub>2<\/jats:sub>) and delayed recovery of dental patients with disabilities after intravenous sedation. A total of 1213 patients with disabilities were retrospectively investigated with respect to demographic parameters and sedation conditions. Multivariate logistic analyses were conducted for patients with an SpO<jats:sub>2<\/jats:sub> &lt;90% and a recovery period of &gt;60 minutes to identify the risk factors for poor sedation conditions. A significant odds ratio related to decreased SpO<jats:sub>2<\/jats:sub> was observed for age, sex, midazolam and propofol levels, concurrent use of nitrous oxide, cerebral palsy, Down syndrome, and mental retardation. The most problematic patients were those diagnosed with Down syndrome (odds ratio, 3.003\u20137.978; 95% confidence interval; <jats:italic>P<\/jats:italic> &lt; .001). Decision tree analysis showed an increased risk of decreased SpO<jats:sub>2<\/jats:sub> in males with Down syndrome or after administration of &gt;0.493 mg\/kg propofol in combination with midazolam. An increased risk of delayed awakening was seen in patients aged less than 21 years and in males administered &gt;0.032 mg\/kg of midazolam. Intravenous sedation for dental patients with disabilities, particularly those with cerebral palsy, Down syndrome, or mental retardation, increases the risk of decreased SpO<jats:sub>2<\/jats:sub>. In addition, delayed recovery is expected after midazolam administration.<\/jats:p>","DOI":"10.2344\/0003-3006-60.4.153","type":"journal-article","created":{"date-parts":[[2014,1,14]],"date-time":"2014-01-14T16:47:35Z","timestamp":1389718055000},"page":"153-161","source":"Crossref","is-referenced-by-count":20,"title":["Risk Factors With Intravenous Sedation for Patients With Disabilities"],"prefix":"10.2344","volume":"60","author":[{"given":"Fumihiro","family":"Yoshikawa","sequence":"first","affiliation":[{"name":"Section of Anesthesiology and Clinical Physiology, Tokyo Medical and Dental University, Tokyo, Japan,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoh","family":"Tamaki","sequence":"additional","affiliation":[{"name":"Center for Public Health Informatics, National Institute of Public Health, Saitama, Japan,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisa","family":"Okumura","sequence":"additional","affiliation":[{"name":"Division of Dental Care, National Medical and Educational Consulting Center, National Welfare Foundation for Disabled Children, Tokyo, Japan,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zenzo","family":"Miwa","sequence":"additional","affiliation":[{"name":"Department of Pediatric Dentistry, Tokyo Medical and Dental University, Tokyo, Japan,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaaki","family":"Ishikawa","sequence":"additional","affiliation":[{"name":"Pediatric Oral Health Care Science, Tokyo Medical and Dental University, Tokyo, Japan,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiro","family":"Shimoyama","sequence":"additional","affiliation":[{"name":"Geriatric Oral Health Care Science, Tokyo Medical and Dental University, Tokyo, Japan,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zenkou","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Tokyo Metropolitan Tobu Medical Center for Persons with Developmental\/Multiple Disabilities, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitomi","family":"Kunimori","sequence":"additional","affiliation":[{"name":"Section of Anesthesiology and Clinical Physiology, Tokyo Medical and Dental University, Tokyo, Japan,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeharu","family":"Jinno","sequence":"additional","affiliation":[{"name":"Section of Anesthesiology and Clinical Physiology, Tokyo Medical and Dental University, Tokyo, Japan,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hikaru","family":"Kohase","sequence":"additional","affiliation":[{"name":"Section of Anesthesiology and Clinical Physiology, Tokyo Medical and Dental University, Tokyo, Japan,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruhisa","family":"Fukayama","sequence":"additional","affiliation":[{"name":"Section of Anesthesiology and Clinical Physiology, Tokyo Medical and Dental University, Tokyo, Japan,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1191","reference":[{"key":"i0003-3006-60-4-153-b01","series-title":"Spec Care Dentist","first-page":"9","article-title":"A review of guidelines for sedation, anesthesia, and alternative interventions for people with special needs","volume":"29","author":"Glassman\n              P.","year":"2009","unstructured":"Glassman\n              P. \n          \n          A review of guidelines for sedation, anesthesia, and alternative interventions for people with special needs. Spec Care Dentist. 2009;29:9\u201316."},{"key":"i0003-3006-60-4-153-b02","series-title":"Acta Anaesthesiol Taiwan","first-page":"122","article-title":"Dental anesthesia for patients with special needs","volume":"50","author":"Wang\n              YC,","year":"2012","unstructured":"Wang\n              YC, \n            \n              Lin\n              IH, \n            \n              Huang\n              CH, \n            \n              Fan\n              SZ. \n          \n          Dental anesthesia for patients with special needs. Acta Anaesthesiol Taiwan. 2012;50:122\u2013125."},{"key":"i0003-3006-60-4-153-b03","series-title":"Br Dent J","first-page":"565","article-title":"Intranasal\/intravenous sedation for the dental care of adults with severe disabilities: a multicentre prospective audit","volume":"208","author":"Ransford\n              NJ,","year":"2010","unstructured":"Ransford\n              NJ, \n            \n              Manley\n              MC, \n            \n              Lewis\n              DA, \n            et al\n          . Intranasal\/intravenous sedation for the dental care of adults with severe disabilities: a multicentre prospective audit. Br Dent J. 2010;208:565\u2013569."},{"key":"i0003-3006-60-4-153-b04","series-title":"Eur J Orthod","first-page":"81","article-title":"Intravenous sedation: an adjunct to enable orthodontic treatment for children with disabilities","volume":"24","author":"Chaushu\n              S,","year":"2002","unstructured":"Chaushu\n              S, \n            \n              Gozal\n              D, \n            \n              Becker\n              A. \n          \n          Intravenous sedation: an adjunct to enable orthodontic treatment for children with disabilities. Eur J Orthod. 2002;24:81\u201389."},{"key":"i0003-3006-60-4-153-b05","series-title":"J Am Dent Assoc","first-page":"740","article-title":"Comparing efficacy and safety of four intravenous sedation regimens in dental outpatients","volume":"132","author":"Dionne\n              RA,","year":"2001","unstructured":"Dionne\n              RA, \n            \n              Yagiela\n              JA, \n            \n              Moore\n              PA, \n            et al\n          . Comparing efficacy and safety of four intravenous sedation regimens in dental outpatients. J Am Dent Assoc. 2001;132:740\u2013751."},{"key":"i0003-3006-60-4-153-b06","series-title":"Anesthesiology","first-page":"1004","article-title":"Practice guidelines for sedation and analgesia by non-anesthesiologists","volume":"96","year":"2002","unstructured":"American Society of Anesthesiologists Task Force on Sedation and Anesthesia by Non-Anesthesiologists. Practice guidelines for sedation and analgesia by non-anesthesiologists. Anesthesiology. 2002;96:1004\u20131017."},{"key":"i0003-3006-60-4-153-b07","series-title":"Anesth Prog","first-page":"116","article-title":"Retrospective outcomes evaluation of 100 parenteral moderate and deep sedations conducted in a general practice dental residency","volume":"55","author":"Messieha\n              Z,","year":"2008","unstructured":"Messieha\n              Z, \n            \n              Cruz-Gonzalez\n              W, \n            \n              Hakim\n              MI. \n          \n          Retrospective outcomes evaluation of 100 parenteral moderate and deep sedations conducted in a general practice dental residency. 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Anaesthesist. 1992;41:335\u2013341."},{"key":"i0003-3006-60-4-153-b12","series-title":"Anesthesiology","first-page":"1283","article-title":"Women emerge from general anesthesia with propofol\/alfentanil\/nitrous oxide faster than men","volume":"90","author":"Gan\n              TJ,","year":"1999","unstructured":"Gan\n              TJ, \n            \n              Glass\n              PS, \n            \n              Sigl\n              J, \n            et al\n          . Women emerge from general anesthesia with propofol\/alfentanil\/nitrous oxide faster than men. Anesthesiology. 1999;90:1283\u20131287."},{"key":"i0003-3006-60-4-153-b13","series-title":"Anaesth Intensive Care","first-page":"207","article-title":"Patient sex and its influence on general anaesthesia","volume":"37","author":"Buchanan\n              FF,","year":"2009","unstructured":"Buchanan\n              FF, \n            \n              Myles\n              PS, \n            \n              Cicuttini\n              F. \n          \n          Patient sex and its influence on general anaesthesia. Anaesth Intensive Care. 2009;37:207\u20132118."},{"key":"i0003-3006-60-4-153-b14","series-title":"Acta Anaesthesiol Scand","first-page":"241","article-title":"Gender differences in drug effects: implications for anaesthetists","volume":"47","author":"Pleym\n              H,","year":"2003","unstructured":"Pleym\n              H, \n            \n              Spigset\n              O, \n            \n              Kharasch\n              ED, \n            \n              Dale\n              O. \n          \n          Gender differences in drug effects: implications for anaesthetists. Acta Anaesthesiol Scand. 2003;47:241\u2013259."},{"key":"i0003-3006-60-4-153-b15","series-title":"Br J Anaesth","first-page":"832","article-title":"Effect of patient sex on general anaesthesia and recovery","volume":"106","author":"Buchanan\n              FF,","year":"2011","unstructured":"Buchanan\n              FF, \n            \n              Myles\n              PS, \n            \n              Cicuttini\n              F. \n          \n          Effect of patient sex on general anaesthesia and recovery. Br J Anaesth. 2011;106:832\u2013839."},{"key":"i0003-3006-60-4-153-b16","series-title":"J Dent Res","first-page":"718","article-title":"The mouth opening increases upper-airway collapsibility without changing resistance during midazolam sedation","volume":"83","author":"Ayuse\n              T,","year":"2004","unstructured":"Ayuse\n              T, \n            \n              Inazawa\n              T, \n            \n              Kurata\n              S, \n            et al\n          . The mouth opening increases upper-airway collapsibility without changing resistance during midazolam sedation. J Dent Res. 2004;83:718\u2013722."},{"key":"i0003-3006-60-4-153-b17","series-title":"J Oral Rehabil","first-page":"203","article-title":"Accumulated oropharyngeal water increases coughing during dental treatment with intravenous sedation","volume":"35","author":"Kohjitani\n              A,","year":"2008","unstructured":"Kohjitani\n              A, \n            \n              Egusa\n              M, \n            \n              Shimada\n              M, \n            \n              Miyawaki\n              T. \n          \n          Accumulated oropharyngeal water increases coughing during dental treatment with intravenous sedation. 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Int J Clin Pract Suppl. 2011;174:8\u201313."},{"key":"i0003-3006-60-4-153-b19","series-title":"Dev Med Child Neurol","first-page":"734","article-title":"Upper airway obstruction with hypoxaemia and sleep disruption in Down syndrome","volume":"29","author":"Southall\n              DP,","year":"1987","unstructured":"Southall\n              DP, \n            \n              Stebbens\n              VA, \n            \n              Mirza\n              R, \n            \n              Lang\n              MH, \n            \n              Croft\n              CB, \n            \n              Shinebourne\n              EA. \n          \n          Upper airway obstruction with hypoxaemia and sleep disruption in Down syndrome. Dev Med Child Neurol. 1987;29:734\u2013742."},{"key":"i0003-3006-60-4-153-b20","series-title":"J Otolaryngol","first-page":"398","article-title":"Surgical management of obstructive sleep apnea in children with Down syndrome","volume":"17","author":"Donaldson\n              JD,","year":"1988","unstructured":"Donaldson\n              JD, \n            \n              Redmond\n              WM. \n          \n          Surgical management of obstructive sleep apnea in children with Down syndrome. 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Arch Otolaryngol Head Neck Surg. 2004;130:741\u2013745."},{"key":"i0003-3006-60-4-153-b22","series-title":"South Med J","first-page":"779","article-title":"Airway obstruction in the mentally handicapped","volume":"85","author":"Kavanagh\n              KT,","year":"1992","unstructured":"Kavanagh\n              KT, \n            \n              Beckford\n              NS. \n          \n          Airway obstruction in the mentally handicapped. South Med J. 1992;85:779\u2013781."},{"key":"i0003-3006-60-4-153-b23","series-title":"Pediatr Dent","first-page":"191","article-title":"Comparison of chloral hydrate, meperidine, and hydroxyzine to midazolam regimens for oral sedation of pediatric dental patients","volume":"27","author":"Chowdhury\n              J,","year":"2005","unstructured":"Chowdhury\n              J, \n            \n              Vargas\n              KG. \n          \n          Comparison of chloral hydrate, meperidine, and hydroxyzine to midazolam regimens for oral sedation of pediatric dental patients. Pediatr Dent. 2005;27:191\u2013197."},{"key":"i0003-3006-60-4-153-b24","series-title":"J Clin Pediatr Dent","first-page":"259","article-title":"The sedative effects of intranasal midazolam administration in the dental treatment of patients with mental disabilities. Part 2: optimal concentration of intranasal midazolam","volume":"18","author":"Fukuta\n              O,","year":"1994","unstructured":"Fukuta\n              O, \n            \n              Braham\n              RL, \n            \n              Yanase\n              H, \n            \n              Kurosu\n              K. \n          \n          The sedative effects of intranasal midazolam administration in the dental treatment of patients with mental disabilities. Part 2: optimal concentration of intranasal midazolam. J Clin Pediatr Dent. 1994;18:259\u2013265."}],"container-title":["Anesthesia Progress"],"original-title":[],"link":[{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/view\/journals\/anpr\/60\/4\/article-p153.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/anesthesia-progress\/article-pdf\/60\/4\/153\/2357631\/0003-3006-60_4_153.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/downloadpdf\/journals\/anpr\/60\/4\/article-p153.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/downloadpdf\/journals\/anpr\/60\/4\/article-p153.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,7]],"date-time":"2024-10-07T12:25:20Z","timestamp":1728303920000},"score":1,"resource":{"primary":{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/view\/journals\/anpr\/60\/4\/article-p153.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013]]},"references-count":24,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.2344\/0003-3006-60.4.153","relation":{},"ISSN":["0003-3006","1878-7177"],"issn-type":[{"value":"0003-3006","type":"print"},{"value":"1878-7177","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013]]}}}