CONSCIOUS SEDATION (MODERATE SEDATION)

A technique that relaxes you during the procedure and leaves you with little or no memory of the experience afterwards.

What is Conscious Sedation?

A minimally depressed level of consciousness, that retains patient’s ability to maintain an airway independently and respond appropriately to physical stimulation and verbal command.

It is a combination of medicines to help you relax (a sedative) and to block pain (an anaesthetic) during a medical or dental procedure.

It lets you recover quickly and return to your everyday activities soon after your procedure.

Why the Procedure is Performed

Conscious sedation is safe and effective for people who need minor surgery or a procedure to diagnose a condition.

Aims & Objectives

  • Guard the patient’s safety and welfare
  • Minimize physical discomfort and pain
  • Control anxiety, minimize psychological trauma
  • Control behavior and movement to allow the safe completion of the procedure
  • These goals can best be achieved by selecting the lowest dose of drug with the highest therapeutic index for the procedure.

Candidates for conscious sedation

  • Infants that are at least 6 weeks old and were full term (>38 weeks)
  • Premature infants whose chronological age + gestation age is greater than 52 weeks
  • Healthy infants not meeting these criteria may be candidates, but MUST be monitored a minimum of 12 hours without apnea post procedure to qualify for discharge

Indications for Conscious Sedation

  • Dental anxiety and phobia
  • Prolonged or traumatic dental procedures
  • Medical conditions potentially aggravated by stress
  • Medical conditions affecting the patient’s ability to cooperate
  • Special needs

Common agents employed

  • GASES- Nitrous Oxide (N2O) & Oxygen (O2)
  • ANTIHISTAMINES
  • BENZODIAZEPINES & ITS ANTAGONIST
  • SEDATIVE HYPNOTICS
  • NARCOTICS & ITS ANTAGONIST

 

Conscious Sedation for Apprehensive Paediatric patients

Inhalation Sedation

Nitrous oxide/oxygen is usually the technique of choice for conscious sedation of paediatric dental patients

Intravenous Sedation

Intravenous sedation for children is appropriate in a minority of cases.

If practical, a topical anaesthetic should be used prior to venous cannulation.

AFTER CARE

Recovery

Recovery from sedation is a progressive step-down from completion of treatment, through to the patient’s discharge into the care of a responsible adult escort.

Discharge

All patients must be individually assessed for their suitability for discharge and should be allowed to leave only when they have returned to a normal level of responsiveness and orientation for age and mental status and can walk unaided (if appropriate).

PRE AND POST-OPERATIVE INSTRUCTIONS FOR PATIENT

Intravenous, Oral and Transmucosal Sedation

Patients should eat normally on the day of their appointment and must avoid alcoholic drinks.

Patients should take routine medication as normal unless advised not to by the treating dentist or anaesthetist.

 

 

For the remainder of the day, patients must not:

- return to work;

- drive a car or other vehicle;

- consume alcohol;

- operate machinery (including kitchen equipment);

- climb heights (e.g. ladders, scaffolding);

- be in charge of other people;

- make important decisions (e.g. signing legal documents).

Risks

Conscious sedation is usually safe. However, if you are given too much of the medicine, problems with your breathing may occur. A health care provider will be watching you during the whole procedure.

Conscious Sedation that is carefully planned and carried out by a thoughtful, well-trained health care team will allow both caregivers and patients to have a positive experience rather than a bad memory…