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Intra Venous Sedation

Intra Venous Conscious Sedation and The Extraction of Wisdom Teeth

IV CONSCIOUS SEDATION

“Sedation is an extremely safe and convenient procedure which will allow you to access surgical procedures without being aware of the treatment. In years past admission to a hospital for a general anaesthetic was the norm, this involved a day in hospital and a long recovery period. With modern sedation techniques and surgical practice wisdom teeth can safely be removed in office under sedation and you will be on your way home within an hour”

Conscious Sedation and Dental Surgery, what to Expect

A consultation, examination and medical history must a completed to assure that treatment is appropriate and safe.

A written list of all medication you are taking is necessary.

A written and verbal explanation of your dental treatment and iv sedation will be discussed.

What must you do before Dental Conscious Sedation

You are asked not to eat for 4 hours and only have a very light meal before this.

You will be asked to provide a full written list of any and all medication you are taking.

An escort must be present to bring you home. You must have arrangements made to remain home in adult company for the remainder of the day.

If there is a medical or other reason that sedation may not be administered your treatment will  be delayed until appropriate arrangements have been made.

http://www.bupa.co.uk/individuals/health-information/directory/l/local-anaesthesia

CLOTHES

Please wear loose fitting, comfortable and modest clothing. You will need to be able to roll your sleeve up past your elbow.

Please wear Flat Shoes (No Heals Please)

Please do not wear low cut tops or short skirts.

AFTER CONSCIOUS SEDATION

You will be required to wait in the clinic for one hour after treatment to allow the sedation to pass.

When you go home you should rest in bed for a further 3 hours. Prop your head up and relax.  (If you lie completely flat you are more likely to bleed). Avoid eating and drinking hot liquids for 3 to 4  hours. Cool liquids are allowed as is very soft food, soup etc.

After 3 / 4  hours most people are able to eat and drink soft food without difficulty.

You should stay home in responsible adult company for the remainder of the day.

YOU MUST NOT DRIVEDRINK ALCOHOLUSE MACHINERY, COOKHANDLE HOT OBJECTS or make IMPORTANT DECISIONS FOR THE REMAINDER OF THE DAY.

The following day you may return to normal activity as the effects of the sedation will have passed completely.

Very rarely, a patient reports feeling a bit foggy for a day or so. This is rare and passes without further treatment.

Occasionally a patient will report that they can remember some of their treatment. This is normal. The memory is usually vague and not upsetting, it has been described as like remembering a movie you have watched. You are aware of what is happening but completely disassociated from it. The vast majority of patients have no memory of treatment at all.

CONTRAINDICATIONS to IV Conscious Sedation include
    • pregnancy,
    • known allergy to Midazolam or midazolam related drugs,
    • alcohol intoxication, 4/CNS depression, and 5/some forms of  glaucoma.
CAUTIONS in the use of IV Conscious Sedation include
    • psychosis,
    • impaired lung or kidney or liver function,
    • advanced age.  Heart disease is generally not a contraindication.

TREATMENT

    1. You will first be offered a painkiller to keep you pain free for the remainder of the day. This is normally a combination of Solpadol (parcaetamol and codeine) and Difene. These painkillers should provide up to 12 hours of good pain relief after your treatment.
    2. A drip is then placed in your arm.
    3. A drug (midazolam) is administered. After 30 to 40 seconds you will feel as if you have drunk some alcohol, most people find this sensation very pleasant.This will  usually be the last thing you remember.  When you recover from the sedation the treatment will be have been completed. Some individuals will have some memory of their treatment , the memory is usually vague and this is perfectly normal.For patients who are only slightly worried or who request a quicker recovery time a smaller dose of sedative will be used. These patients will probably remember most of their treatment. However they are so relaxed as not to have any cares about remembering their treatment.Occasionally a patient will attend for treatment with a high tolerance for sedative drugs and while they become relaxed they have full memory of the whole procedure. There is never a 100% guarantee that a patient will have absolutely no memory of the treatment, but it is the normal for most patients.
    4. Dexamethasone is also administered. Dexamethasone has several effects.
      1.  Dexamethasone  will reduce the swelling associated with the removal of wisdom teeth. 
      2.  Dexamethasone will also help prevent post of nausea and vomiting.
      3.  Dexamethasone will reduce the level of post operative pain and the need for painkillers.
        Some Information On Dexamethasone
        http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2044.1993.tb07474.x/abstract
        http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1356141/
        http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1291385/
        http://www.ncbi.nlm.nih.gov/pubmed/8491244
    5. You will be asked to remain  in the dental chair until you recover from the dental  sedation and your escort can then bring you home.This normally takes about one hour.  Some people will recover quicker than this and some people will take longer to recover, it will vary from individual to individual.You must demonstrate that you are able to walk and talk in a normal manner and that the drunk feelings must have passed. The  time this takes will vary with individuals.  Some individuals will need to go home to bed for several hours and they may feel sleepy for the remainder of the day. Every individual is different and must be dealt with as such.

    Some Information On Midazolam

    http://en.wikipedia.org/wiki/Midazolam

    http://www.drugbank.ca/drugs/DB00683

    http://www.mims.com/USA/drug/info/midazolam/midazolam?type=full

For more information on wisdom teeth, click wisdom teeth  and for other dental procedures, click Dental Procedures.