The Failed Sedation: Solutions for the Oral and Maxillofacial Surgeon

Failed sedation is the inability to satisfactorily complete a planned procedure [with sedation]. Failed sedation is an inexorably entwined, multifactorial event, which can be due to unsuitable patient, procedure or facility choices; inappropriate drug selection/dose, adverse drug response, and/or lack of a shared, structured and realistic anesthetic plan. The true incidence of failed sedation in the OMFS office is unknown, but can approach 1 case per month Failed sedation can best be prevented by communication and realistic alignment of patient expectations. Management of failed sedation will most often include lightening anesthetic depth and/or aborting the planned procedure, with patient safety remaining the top priority.