449 - Assessment of the Traffic Light Model for Pediatric Sedation Dentistry

Assessment of the Traffic Light Model for Pediatric Sedation Dentistry
Rusnak K, Goldberg-O’Neil E, Langen A, Heard C
University at Buffalo, Buffalo NY

Purpose: The purpose of this study is to determine if our traffic light model faithfully mimics real-life sedation airway outcomes for pediatric oral sedation, pediatric moderate IV sedation, and pediatric deep IV sedation.

Methods: After IRB approval we performed a retrospective chart review of pediatric patients that utilized our sedation suite services in 2021. We reviewed pediatric oral conscious sedation, moderate and deep IV sedation. We applied our traffic light airway model to determine if our patient results mimic predefined expected airway outcomes (green light), acceptable airway outcomes (yellow light), and unacceptable airway outcomes (red light) for depth and type of sedation administered.

Results: We have reviewed 595 charts. Oral conscious sedation (n=234), mean age 5.8 years, mean dose of 15.0 mg midazolam. Moderate IV (n=107), mean age 7.4 years, mean dose of 4.5 mg midazolam and 64.8 mcg fentanyl. Deep IV (n=254), mean age of 6.5 years, mean dose 3.3 mg midazolam, 47.3 mcg fentanyl, and 135.7 mg propofol. 6.22% of total patients experienced red light events, 52.27% experienced yellow light events, and 41.52% had green light events. The most red light events (30 cases) were seen in moderate intravenous sedation.

Conclusions: Levels of sedation and required airway interventions require further study in order to improve safety. The traffic light model can be utilized as a tool to help practitioners remain within their scope for appropriate level of sedation.