518 - Impact of Low BMI on Moderate Sedation Outcomes in the Dental Office

Purpose: To examine if BMI predicts over-sedation among pediatric patients with lower BMIs undergoing dental treatment under oral conscious sedation.
 

Methods: Retrospective chart review of patients at Children’s Hospital Colorado ages 2-18 years old who have undergone moderate procedural sedation in the dental clinic, with data extracted from 2019-2021. Patients were defined as exposed to “over-sedation” if they met any one of the following parameters: decreased heart rate (HR) below 60 bpm; decrease in HR 20% below baseline; hypoxemia SpO2 < 90%; hypotension >20% reduction in pre-sedation blood pressure (BP), a Ramsey score between 4-6 indicating deep sedation; increased time to discharge ( >120min post medication administration), or report of difficulty arousing patient.
 

Results: 131 patients were included in over-sedation analysis. 44 (32.8%) patients had one clinical sign of over-sedation, 18 (13.4%) had two signs, and 1 (0.8%) had three signs. Over-sedation variables with high % of incidence were grouped (labeled “Post-Hoc Over-sedation”) and logistic regression model was used to test significant association between BMI/BMI percentile of patient and over-sedation. “Post-Hoc Over-sedation,” defined as 20% decrease in pre-sedation BP, decrease in HR 20% below baseline, and Ramsey score between 4-6, was found to have a statistically significant (P= 0.0445) correlation with BMI percentile, whereby every 10% increase in BMI percentile was associated with 14% increased odds of over-sedation.

Conclusion: No statistically significant relationship was found between low BMI and over-sedation.