Outpatient IV sedation for dental care in special needs patients shows 3.3% minor complication rate

Patients with special health care needs (SHCN) frequently present behavioral and medical conditions that complicate conventional dental treatment. This study aimed to describe the clinical profile, dental procedures, pharmacological protocols, and safety outcomes of outpatient intravenous sedation in SHCN patients treated in a specialized center in Venezuela. A retrospective review was conducted of all SHCN patients who received outpatient intravenous sedation for dental treatment at a private clinic in Caracas, Venezuela, between January 2019 and December 2024. Demographic data, type of disability, American Society of Anesthesiologists (ASA) physical status, dental procedures performed, sedative and analgesic regimens, duration of treatment and sedation, number of sedation sessions, intraoperative oxygen saturation, and complications were extracted from electronic records. Only patients classified as ASA I–III with complete medical and dental charts were included. Data were analyzed using descriptive statistics (means and standard deviations for continuous variables; frequencies and percentages for categorical variables). Group comparisons, when performed, used chi-square or Fisher's exact tests for categorical variables and t tests or Mann–Whitney U tests for continuous variables, with a significance level of 0.05. A total of 212 SHCN patients (70.8% male; mean age 11.1 ± 10.5 years) underwent 2,269 dental procedures under intravenous sedation. Autism spectrum disorder was the most frequent condition (34.0%), followed by dental phobia (16.5%), Down syndrome (16.0%), and very young uncooperative children (13.7%). Restorative procedures accounted for 52.2% of all treatments, preventive/periodontal procedures for 27.8%, and surgical interventions for 20.0%. The most common drug regimens were midazolam–fentanyl–ketamine (34.0%) and midazolam–fentanyl–propofol (27.4%). Oxygen saturation remained ≥90% in all but one transient episode, and minor complications occurred in 3.3% of sedations. Outpatient intravenous sedation was feasible for delivering comprehensive dental care to patients with special health care needs within a specialized outpatient clinic. A low observed complication rate and limited need for repeated sedation sessions were documented, supporting its use as a contextualized clinical approach when performed by trained teams under strict monitoring protocols.