Effect of patient position and verbal interaction on recovery following intravenous sedation

Aim To investigate if recovery position and verbal interaction with the patient post sedation influences the recovery time for patients receiving intravenous conscious sedation following oral surgical procedures. Material and methods A randomised, prospective, single‐centre clinical trial was carried out in Dublin Dental University Hospital in the sedation day unit during the time period of March 2005–February 2006. Seventy‐three patients meeting the following criteria were recruited: requiring an oral surgery procedure under intravenous sedation, American Society of Anaesthetists classification I or II, no history of kidney/liver disease, 18–65 years of age, and neither pregnant nor breastfeeding. Patients were randomly assigned a position of recovery, which was either sitting, semi‐prone or lying with or without gentle verbal interaction, and recovery time to discharge from professional care was recorded. Two recovery times were recorded as the times to discharge from professional care. One from the last increment of drug (midazolam) given, known as ‘post‐midazolam recovery time’, and the second time from the end of the operative procedure, known as ‘post‐operative recovery time’. Results Position was significantly associated with outcome for both post‐midazolam recovery time (P = 0.046) and post‐operative recovery time (P = 0.010), with patients in the sitting position recovering more quickly than those in the supine position. Conclusion Variability in recovery times is significantly related to recovery position. Patients if haemodynamically stable should be recovered in a sitting position.