Sedation & Special Care

Question 1

common pt group

Answer 1

involuntary movements -
congenital = muscular dystrophy, cerebral palsy, MS, parkinson’s, huntington’s
acquired = head injury

learning difficulties
congenital = syndromic & non syndromic
acquired = trauma, infection, CVA, alzheimer’s

Question 2

requirements for IS

Answer 2

pt must be able to breathe through their nose with their mouth open which can be difficult in special care pt so this must be assessed
will behaviour management be possible
will they need GA
is pharmacological management needed

Question 3

conscious sedation techniques

Answer 3

inhalational
intravenous
oral
transmucosal (rectal)
intranasal
sublingual

Question 4

choice of sedation technique

Answer 4

patient cooperation
degree of anxiety
dentistry required
skills of dental team
pt previous experience
facilities available

Question 5

IS adv & disadv

Answer 5

+ useful for anxiety relief
+ rapid recovery
+ flexible duration
- keeping nasal hood in place
- less muscle relaxation
- coordination of nasal breathing when mouth open

Question 6

IV sedation +/-

Answer 6

+ good sedation achieved
+ less cooperation needed
+ muscle relaxation
- baseline readings
- IV cannulation required
- assessing sedation level
- behaviour during recovery
- efficacy swallowing

Question 7

safety to consider in IV sedation

Answer 7

swallowing
airway
liver
medication interactions
ASA (health classification)

Question 8

oral / transmucosal sedation +/-

Answer 8

+ avoid cannulation
+ induction more pleasant
+ better cooperation
+ better future behaviour
- baseline readings
- bitter taste / sting
- lag time
- untitrateable
- difficulty monitoring level of sedation
- behaviour in recovery
* can be difficult to obtain from pharmacy as need high concentration for nasal / oral to work

Question 9

requirement when sedating

Answer 9

must always place cannula so you can reverse or add more sedation if required