Advanced sedation in oral surgery as an alternative to General Anaesthetic: A service evaluation

Aim The management of dentoalveolar procedures under general anaesthetic has been a widespread challenge recently. The establishment and implementation of an advanced sedation service within the oral surgery department at Liverpool University Dental Hospital offered a potential alternative to managing those awaiting procedures. A comprehensive service evaluation aimed to demonstrate that patients previously considered for general anaesthetic could be safely and efficiently managed with an advanced sedation service. Materials and Methods The service evaluation employed mixed methods; a data collection tool captured procedural demographics retrospectively whilst a patient‐reported outcome measure (PROM) was designed to engage patients regarding their experience. Results The service evaluation highlighted that 27% of patients previously listed for general anaesthetic were managed with local anaesthetic or conscious sedation alone. The sedation outcomes demonstrated that all patients were co‐operative and achieved an optimal level of sedation. No adverse sedation outcomes were recorded. Patient‐reported outcomes were positive with 100% rating it as an excellent service. Conclusions The use of an advanced sedation service has demonstrated successful outcomes and reduced reliance on theatre resources. The use of polypharmacy; midazolam and propofol, provides a safe, effective and efficient modality to perform complex procedures in an outpatient hospital setting. Advanced sedation techniques can be particularly effective in the management of complex procedures, dental anxiety and in adolescent and medically complex patients. Patient engagement supports the service as an effective option for delivering quality care.