COMPUTER-CONTROLLED INFUSION OF PROPOFOL FOR CONSCIOUS SEDATION IN DENTAL TREATMENT

Objective To assess a drug delivery system that can rapidly achieve an d maintain a constant blood concentration of Propofol (2,6 di-isopropy l phenol) which, in subanaesthetic doses, is an effective intravenous sedative for treating anxious or handicapped patients in dentistry: De sign The clinical use of a computer controlled infusion system to indu ce and maintain conscious sedation with propofol was prospectively stu died. Based on a 3-compartment pharmacokinetic model, the system calcu lates the initial bolus dose and infusion rates to achieve a user-sele cted target blood concentration. Setting Amsterdam Center for Special Dental Care. Subjects 89 patients attending for dental treatment. Resu lts Treatment could be performed within 2 minutes after the onset of t he infusion. The median therapeutic target blood propofol concentratio n was 2.5 mu g/ml and the median recovery time was 9 minutes. Transien t oversedation (38 procedures) could easily be treated by decreasing t he target concentration. No adverse cardiorespiratory effects resulted from propofol sedation. Venous blood propofol concentrations were mea sured in 25 anxious patients. The kinetic data set used in this study underestimated the distribution and elimination of propofol in our pat ients. Conclusions Computer controlled infusion of propofol can provid e satisfactory and safe conscious sedation in dental patients.