Capnometry monitoring during intravenous sedation with midazolam for oral surgery

Abstract Aims To investigate changes in end‐tidal carbon dioxide (ETCO2) and the utility of ETCO2 as an additional monitor of ventilation during intravenous sedation with midazolam for oral surgery. There are no data on capnography in dental sedation, nor is the frequency of abnormal ventilatory activity known in this setting. Materials and methods This was a prospective observational study of 33 healthy adults (mean age 38 years). Monitoring included pulse oximetry, blood pressure measurement and visual assessment. Patients were also monitored with blinded capnometry. Results Post‐hoc analysis revealed 33% of patients had peripheral capillary oxygen saturation (SPO2) < 95% and 30% had ETCO2 changes indicating respiratory depression. Mean increase in ETCO2 was 2.19 mm Hg (95% confidence interval = 0.83–3.55) P = 0.0025 during sedation. Conclusion During intravenous sedation for oral surgery in healthy adult's breathing room air, significant changes in ETCO2 values occur. However, desaturation detectable by pulse oximetry usually occurs before clinically significant changes in capnometry are recognisable.