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SAAD Digest
March 2024
Volume: 40
Issue: 1

Title: An audit of the use of flumazenil for sedation within the Special Care Dentistry Department (CDS Cycle 7) and seven-year comparison
Author(s): H. J. Smith, R. Jaffery 

Abstract: 

Background
Flumazenil is a benzodiazepine antagonist which acts at GABA receptor sites to reverse the sedation effects of midazolam in dental conscious sedation. National Patient Safety Agency Rapid Response Report 2008 identified several cases where patients were being over sedated with midazolam and recommended auditing of flumazenil use as a measure of midazolam oversedation.

Aims
The audit aims to review the number of patients within the Birmingham Community Healthcare NHS Foundation Trust’s Community Dental Service who underwent sedation with midazolam and those who required reversal with flumazenil. It also aims to review the record keeping of the justifications given for flumazenil reversal and to ensure compliance with National Patient Safety Agency’s 2008 recommendations. 

Methods
Data for patients who underwent intravenous / transmucosal sedation with midazolam between January 2023 and June 2023 were taken from the Community Dental Service’s electronic logbook. Clinical records were then reviewed for documentation of justification.

Results
For cycle seven, (0%) no anxious adult patients required reversal with flumazenil, whereas 5.6% of special care patients (n = 5) required reversal. The majority of reversals cited prolonged recovery as the reason for its use.

Conclusion
The findings demonstrate compliance with National Patient Safety Agency’s recommendations, excellent record keeping and justification of flumazenil use.

If you have a query relating to this article please email: digest@saad.org.uk

Articles from Digest 40(1)

 Article title
 Page start
Page end
 Editorial
 2
 2
Peer reviewed papers
Remimazolam compared to midazolam for dental sedation: an umbrella review
 3
 8
A review of the awareness and use of airway assessment techniques in conscious sedation in dentistry
 9
 14
Improving safety and efficiency in special care dentistry through quality improvement of patient information in the Belfast Trust  
 15
 18
Patient experiences and outcomes following intravenous sedation in an oral surgery setting 
 19
 22
An investigation of bispectral index monitoring when providing intravenous sedation for adults with severe cognitive disability 
 23
 27
Are we providing an effective sedation service? An evaluation of a new conscious sedation service in primary special dental care 
 28
 32
An audit of the use of flumazenil for sedation within the Special Care Dentistry Department (CDS Cycle 7) and seven-year comparison 
 33
 36
Unsuccessful conscious sedation on patients with a learning disability and / or autism: a multi-site service evaluation
 37
 41
The effectiveness of dental nurse led Cognitive Behavioural Therapy (CBT) on the dentally anxious patient: a service evaluation
 42
 46
Case reports
Dental treatment for a 15-year-old patient with Nicolaides- Baraitser Syndrome, under intravenous sedation with midazolam: a case report
 47
49 
The use of inhalation sedation to manage delayed eruption of permanent teeth, hypodontia and caries in a child patient 
 50
53
Case report: A paediatric patient with molar incisor hypomineralisation and hypodontia, treated with inhalation and intravenous sedation for extractions of deciduous and permanent molars 
 54
 56
Opinion
 57
 59
Journal Scan
 60
 68
Essay prizes
Dexmedetomidine: pharmacology and use as a sedative agent 
 69
 76
Do children from more deprived backgrounds have a higher chance of becoming dentally anxious?
 77
 80
Symposium 2023
 81
 89
Profile
 90
90 
Forum  92 97