3 - Introduction to anxiety control Flashcards
Define consicous sedation.
Technique using a drug that produces a state of depression of the CNS enabling treatment to be carried out, during which verbal communication is maintained with the patient. The drug used to carry out conscious sedation has a wide margin of safety to render unintended LOC unlikely.
What is deep sedation?
When verbal contact is lost with the patient - this is considered GA
What medical conditions are indicators for conscious sedation?
Conditions that are aggravated by stress (but are generally well controlled):
- ischaemic heart disease
- hypertension
- asthma
- epilepsy
- psychosomatic illness
- UC or Crohn’s
Conditions that affect cooperation:
- mild/moderate movement or learning difficulties
- spasticity disorder
- parkinsons
What psychosocial conditions are indicators for conscious sedation?
- phobias
- gagging
- persistent fainting
- idiosyncrasy to LA
Define a phobia.
Irrational or uncontrollable fear which is related to a specific object or situation, and is persistent despite avoidance of stimulus
What are the causes of dental anxiety?
- trauma from previous experience
- transference (learned) from parents or on the playground
- fear of criticism (from dentist)
- white coat syndrome
- lack of communication
- helplessness and invasion of private space
What are dental indications for sedation?
- difficult or unpleasant procedures (ie wisdom teeth or orthodontic extractions)
- anxiety
What are medical contraindications for sedation?
- severe or uncontrolled systemic disease
- severe mental or physical disability
- severe psychiatric problems
- narcolepsy
- hypothyroidism
- myasthenia gravis
Why is narcolepsy a contraindication for sedation?
If patient suddenly falls asleep then communication is lost and this is deep sedation
Why is myasthenia gravis a contradiction for sedation?
- a muscle wasting disorder
- midazolam is a muscle relaxant so may affect breathing
What is ASA classification 1?
Normal healthy patient
What is ASA classification 2?
Patient with mild systemic disease that is well controlled
What is ASA classification 3?
Patient with severe systemic disease (or uncontrolled disease such as diabetes)
What ASA classification can dentists sedate?
1 and 2
What are medical contraindications for IV sedation?
- intracranial pathology
- COPD
- myasthenia gravis
- hepatic insufficiency
- pregnancy and lactation
