adult sedation Flashcards
What are the steps we can take to manage a patient in levels of severity?
- Communication2. LA3. Psychological techniques 4. Inhalation sedation 5. IV sedation 6. General anaesthetic
Why is there a need for sedation?
- Theres a high Prevalence of dental anxiety2. Its Stressful for the dentist to manage anxious patients 3. GDC obligations
Define conscious sedation
A technique in which the use of a drug or drugs produces a state of depression of the central nervous system enabling treatment to be carried out, but during which verbal contact with the patient is maintained throughout the period of sedation. The drugs and techniques used to provide conscious sedation for dental treatment should carry a margin of safety wide enough to render loss of consciousness unlikely.
Who needs sedation?
- needle/ dental phobic2. Patients who have a strong gag reflex3. If the dental procedure is especially unpleasant4. Patients with medical conditions
Name some medical conditions that can be| aggravated by the stress of dental treatment
- Moderate ischaemic heart disease2. Mild hypertension 3. Mild Epilepsy4. Mild Asthma
Name some medical conditions that can be| affect co coperation
- Parkinson’s disease2. Spasticity disorders3. Mild mental or physical handicap
Name some social Contraindications to sedation
- Alcohol use2. Drug use3. Lack of an appropriate adult escort 4. Consent issues5. Interactions with sedative drugs6. Not safe
Name some medical Contraindications to sedation
- Severe / uncontrolled / un-investigated systemic disease2. Medication interactions with sedative agent3. Allergy to sedative agent4. Pregnancy5. Psychosis6. Respiratory infection
What scale do we use to judge a patients Anaesthesiology Classification?
American Society of Anaesthesiology Classification of Physical Status (ASA)
Describe a patient placed in the 1st class of the American Society of Anaesthesiology Classification of Physical Status (ASA)
I- Normal, healthy patient
Describe a patient placed in the 2nd class of the American Society of Anaesthesiology Classification of Physical Status (ASA)
II - A Patient with mild systemic disease e.g. well controlled diabetes or epilepsy,mild asthma.
Describe a patient placed in the 3rd class of the American Society of Anaesthesiology Classification of Physical Status (ASA)
III - A patient with severe systemic disease limiting activity but not incapacitating e.g. Uncontrolled hypertension, recent myocardial infarct
Describe a patient placed in the 4th class of the American Society of Anaesthesiology Classification of Physical Status (ASA)
IV - A patient with incapacitating disease that is a constant threat to life
Describe a patient placed in the 5th class of the American Society of Anaesthesiology Classification of Physical Status (ASA)
V - Moribund patient not expected to live more than 24 hours with or without treatment
Name some dental Contraindications to sedation
Some anterior tooth dentistry difficult with inhalation sedationMulti-rooted endodontics & long procedures not ideal