6 - Intravenous sedation Flashcards
1
Q
What is the action of benzodiazepines?
A
- act on receptors in CNS to enhance the effect of GABA (inhibitory neurotransmitter)
- mimics the effects of glycine
2
Q
What effect do benzodiazepines have on respiratory depression?
A
- CNS depression and muscle relaxation
- decreases cerebral reposes to increased levels of CO2
- synergistic effects with other respiratory depressants (increased respiratory depression in already compromised patients)
3
Q
What effect do benzodiazepines have on the cardiovascular system?
A
- decreased BP caused by muscle relaxation decreasing vascular resistance
- increased heart rate due to baroreceptor reflex to low BP
4
Q
What drug interactions are common with benzodiazepines?
A
- CNS depressants
- erythromycin
- antihistamines
5
Q
What is the brand name of midazolam commonly used?
A
Hypnovel
6
Q
What is the elimination half life of midazolam?
A
90-150 mins
7
Q
Where is midazolam metabolised?
A
Liver
8
Q
What staff are required in intravenous sedation?
A
- operator
- sedation trained nurse
- a runner/receptionist available as above persons cannot leave the room
9
Q
Describe the dorsum of the hand as a cannulation site.
A
- accessible
- superficial and visible
- poorly tethered
- affected by peripheral vasoconstriction when cold
10
Q
What are the two cannulation sites used in dentistry?
A
- dorsum of the hand
- antecubital fossa
11
Q
What increments do you use to administer midazolam?
A
- initial bolus 2mg
- 1mg increments every minute
12
Q
What are the signs that adequate sedation has been achieved?
A
- slurring and slowing of speech
- relaxed
- delayed response to commands
- willingness to accept treatment
- ptosis (droopy eyes)
- loss of motor coordination
13
Q
What is Verrill’s sign?
A
Ptosis
14
Q
What is Eve’s sign?
A
- loss of motor coordination
- unable to touch nose with eyes closed
15
Q
How long is the window of useable working time?
A
30-45 mins
