Sedation

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.

Question 2

what are the types of conscious sedation?

Answer 2

• inhalation
• intra venous
• oral

Question 3

what is inhalation sedation?

Answer 3

• use of nitrous oxide and oxygen
• delivered as gas via nose piece mask
• anxiolytic effect
• analgesic effect

Question 4

what are the indiactions to do IHS?

Answer 4

• mild anxiety
• needle phobia
• patient not suitable for IV/GA
• straightforward dental tx

Question 5

what are the contrainidcations of IHS?

Answer 5

• are they able to cooperate?
• age
• learning disabilities/cognitive impairment
• ability to tolerate mask
• mask may impeded access to anteriors
• need to breath through their nose
• COPD
• recent eye or ear surgery
• pregnancy
• chemo interaction
• methotrexate interaction
• vit b12 deficiency

Question 6

what are the side effects from nitrous oxide after IHS?

Answer 6

• headache
• nausea
• vomiting
• diffusion hypoxia

Question 7

what is diffusion hypoxia?

Answer 7

when nitrous oxide is discontinued, it leaves blood quicker than nitrogen from air is absorbed, can lead to dilation of oxygen in the lungs - this is why oxygen is administered after cessation for 5 minutes to prevent thid

Question 8

what is intravenous sedation?

Answer 8

• delivered as an injection
• most commonly midazolam
• mild - moderate anxiety
• need to cannulate
• need for escort
• amnesia
• must have reversal drug - flumazenil

Question 9

what is oral sedation?

Answer 9

• delivered as a drink
• usually midazolam
• less common than IHS or IV
• NOT the same as pre med
• must still cannulate for safety

Question 10

what drugs do we use in sedation?

Answer 10

diazepam - pre med
temazepam - alternative pre med
midazolam - conscious sedation
flumazenil - reversal agent