Retrospective evaluation of intraoperative adverse events among pediatric dental patients undergoing deep sedation: a cross-sectional study

This study aimed to investigate how the frequency and severity of hypoxemia in pediatric dental procedures performed under deep sedation are affected by the type and number of procedures; it also examines the relationship between propofol-related adverse events and anesthesia/procedure duration, drug dosage and patient characteristics. This observational study was performed on cases treated under deep sedation between July 2024-July 2025. The following data were recorded: patient-specific demographic data [age, sex, Body Mass Index (BMI)-percentile, tonsillar hypertrophy and American Society of Anesthesiologists (ASA) status]; dental procedure (restorative, preventive, endodontic treatments and tooth extraction) and intraoperative events (desaturation, bradycardia and tachycardia). Data were evaluated using Shapiro-Wilk, Kruskal-Wallis H and Chi-square tests (p < 0.05). A total of 504 patients were included, of whom 10.3% experienced hypoxemia, 1.8% bradycardia and 2.0% tachycardia. No significant associations were observed between hypoxemia and age, sex, BMI percentiles or ASA status (p = 0.151; p = 0.258; p = 0.098 and p = 0.234, respectively). However, significant results was identified between hypoxemia and anesthesia duration (p = 0.003), procedure duration (p = 0.001) and total propofol dosage (p = 0.001). Extractions were found to be significantly associated with hypoxemia (p = 0.006). Conversely, restorative, fissure sealant and endodontic treatments demonstrated absence of significance (p = 0.078; p = 0.062 and p = 0.356, respectively). Tonsillar hypertrophy (p = 0.0001) and bradycardia (p = 0.001) exhibited a significance with hypoxemia. Within the limitations of this study, it has been observed that the duration of anesthesia, the administration of higher propofol doses, the occurrence of multiple extractions, and the presence of tonsillar hypertrophy have been associated with a significant increase in the risk of hypoxemia.