Sedation - Special Care Flashcards

1
Q

What problems are associated with providing dental treatment for a special care patient? (5)

A

Communication
Anxiety
Unable to sit/cooperate for dental treatment
Perception of reality
Previous experience

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2
Q

List congenital/genetic causes of movement disorders. (5)

A
  • Muscular dystrophy
  • Cerebral Palsy (uncontrolled movements)
  • Multiple Sclerosis
  • Parkinson’s Disease
  • Huntingdon’s Chorea
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3
Q

List acquired causes of movement disorders. (1)

A

head injury

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4
Q

List congenital/genetic causes of learning difficulties. (2)

A
  • Syndrome
  • Non-syndrome
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5
Q

List acquired causes of learning difficulties. (4)

A
  • Trauma
  • Infection
  • CVA
  • Alzheimer’s
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6
Q

How is oral sedation carried out?

A

Patient drinks oral midazolam (20ml) Infront of dentist
- not the same as premed

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7
Q

What are the advantages of oral sedation? (4)

A

• Avoids canulation – cannot tolerate canula = indication for use
• Can make induction more pleasant
• Ensure better px coordination
• Improves future behaviour

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8
Q

What are the disadvantages? (7)

A

• Requires baseline readings (monitored throughout)
• Takes 30 mins to be absorbed and act on sedation levels
• Poor taste – bitter or stinging
• Untitratable
• Difficult to monitor level of sedation
• Difficulty in controlling behaviour during recovery
• Unpredictable - should be avoided where possible

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9
Q

What method of sedation Is commonly used in special care?

A

transmucosal sedation - intranasal

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10
Q

How is intranasal transmucosal sedation carried out?

A

Concentrated midazolam squirted into the nose via a syringe with an atomiser (creates fine mist which attaches to the nasal mucosa)

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11
Q

What are the advantages of intranasal transmucosal sedation? (6)

A

• Avoids first pass metabolism = quicker and reliable
- Sedated within 7 mins

• Sedation comparable to the dose required since no FPM

• No canulation = more cooperation

•. Can make induction more pleasant
• Ensure better px coordination
• Improves future behaviour

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12
Q

What are the disadvantages of intranasal transmucosal sedation? (4)

A

• Doesn’t completely avoid canulation as patients require canula once sedated to allow easy access if they become oversedated as we need to reverse it.

•. Poor taste – bitter or stinging
• Untitratable
• Difficult to monitor level of sedation
• Difficulty in controlling behaviour during recovery

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