Anesthesia & Pain Management Insider: New sedation guidelines call for 2 experts per procedure

Dear Anesthesia & Pain Management Insider,

The American Academy of Pediatric Dentistry and American Academy of Pediatrics have updated their sedation guidelines for the first time in three years. The new guidelines call for two personnel with advanced training to be present when providing deep sedation or general anesthesia to children. Read more in our Insider Exclusive.

The death of a child following sedation is always a tragedy, and one that we're writing about with alarming frequency. Just last month a 4-year-old boy died after being sedated for a dental procedure at a practice in California, a state where sedation legislation has been particularly contentious. In 2016, California passed reporting requirements for pediatric sedation, but a stricter, follow-up bill was pulled the following year. Some advocates believe the current legislation does not go far enough to mandate supervision during dental sedation procedures.

In other Anesthesia & Pain Management Community news, U.S. dentists write significantly more opioid prescriptions than their British counterparts. The proportion of prescriptions written by U.S. dentists was 37 times greater than those written by English dentists, researchers found. They're worried this excess prescribing could be contributing to the opioid epidemic.

Like most dental professionals, you probably write prescriptions for narcotic medications or treat patients who take them. But how familiar are you with their side effects? Periodontist Dr. Alvin Danenberg wrote candidly about his experience taking Percocet, including the unpleasant consequences.

Finally, if you want to avoid prescribing an opioid, is cold therapy a viable alternative? The results of a scientific review are mixed. While cold may be helpful for managing swelling, its benefits for pain management are questionable.

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