Intro to pain and anxiety control

Question 1

What is conscious sedation

Answer 1

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 unintended loss of consciousness unlikely

Question 2

What are the indications for sedation

Answer 2

Medical:
Conditions aggravated by the stress of dental treatment
-Ischaemic heart disease
-Hypertension
-Asthma
-Epilepsy
-Psychosomatic illness

Conditions which affect cooperation:
-Mild to moderate movement or learning difficulties
-Spasticity disorders
-Parkinson’s disease

Psycho social:
-Phobias;Things in mouth,Dental Procedures,Needles,Drills
-Gagging
-Persistent fainting
-Idiosyncrasy to LA

Dental:
-Difficult or unpleasant procedures
-Surgical extraction of wisdom teeth
-Orthodontic extractions
-Implants

Question 3

What are the contraindications for sedation

Answer 3

Medical:
-Severe or uncontrolled systemic disease
-Severe mental or physical disability
-Severe psychiatric problems
-Narcolepsy
-Hypothyroidism

Social:
-Unwilling
-Uncooperative
-Unaccompanied
-Children - for IV
-Very old

Dental:
-Procedure too difficult for LA alone - if patient willing
-Procedure too long
-Spreading infection; Airway threatening, Limits LA
-Procedure too traumatic

Question 4

What is the ASA classification system

Answer 4

a grading system to determine the health of a person before a surgical procedure that requires anesthesia

Question 5

What are the classifications of the ASA system

Answer 5

1)A normal healthy patient
2)A patient with mild systemic disease
3)A patient with severe systemic disease
4)A patient with severe systemic disease that is a constant threat to life
5)A moribund patient who is not expected to survive without the operation
6)A declared brain-dead patient whose organs are being removed for donor purposes

Question 6

What are the contraindications for IVS

Answer 6

Intracranial pathology
COPD
Myasthenia gravis
Hepatic insufficiency
Pregnancy and lactation

Question 7

What are the contraindications for inhalation sedation

Answer 7

Blocked nasal airway
COPD
Pregnancy

Question 8

What are the Adv and DisAdv of sedation

Answer 8

Advantages

Decrease dentist stress
Decrease staff stress
Decrease patient stress
Fewer Medical Incidents
More productive appointments

Disadvantages

Training required
Equipment required
Recovery time and after care