U of A study could lead to change in how dental patients are administered sedation

Doug Lobb, lead investigator and professor in the School of Dentistry. Photo submitted.

A new University of Alberta study shows that the use of a target-controlled infusion (TCI) pump for patient sedation is just as safe as manual injections made by clinicians. 

The study also found patients receiving TCI sedation also had significantly shorter recovery times.

A TCI pump is a device that is controlled by artificial intelligence (AI). TCI sedation involves administering intravenous sedation while monitoring the electrical activity of the brain to ensure patients are adequately sedated. This highly specialized technique is used widely around the world but not in Canada.

“For the past 50 years, Canadian dentists have manually provided bolus injections to sedate patients,” says Doug Lobb, lead investigator and professor in the School of Dentistry. Removing the need for manual injections reduces the potential for human error during administration, he says.

“A potentially better method in many situations involves precision drug administration by TCI pumps. This technique has been shown to be just as safe if not safer and has been in use worldwide for over 25 years. Basically, TCI pumps precisely control the drugs in a patient’s system to the perfect level for that individual.”

Drug-specific pharmacokinetic software and a microprocessor control the pump and drug administration. This combination produces stable, steady-state drug concentrations in the blood and brain for the duration of the procedure. The dentist selects an appropriate initial drug concentration and programs the pump. The AI software then administers the drug to meet the required concentration.

TCI technology has yet to be rigorously studied for moderate dental sedation in Canada. Dental colleges are unfamiliar with this system of sedation and the control it provides and thus have been reluctant to approve its use.

“This is why this clinical research study is so important: It provides peer-reviewed evidence of its safety, risk reduction and improved patient care,” says Lobb. “It has the potential to change and improve how we sedate patients and how we train dentists here in Alberta and across Canada.”

The next step for the research team will be to get approval to replicate the results of a larger New Zealand study using two TCI pumps that showed that the use of TCI sedation is safe.