what is 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.
what are the types of conscious sedation?
- inhalation
- intra venous
- oral
what is inhalation sedation?
- use of nitrous oxide and oxygen
- delivered as gas via nose piece mask
- anxiolytic effect
- analgesic effect
what are the indiactions to do IHS?
- mild anxiety
- needle phobia
- patient not suitable for IV/GA
- straightforward dental tx
what are the contrainidcations of IHS?
- 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
what are the side effects from nitrous oxide after IHS?
- headache
- nausea
- vomiting
- diffusion hypoxia
what is diffusion hypoxia?
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
what is intravenous sedation?
- delivered as an injection
- most commonly midazolam
- mild - moderate anxiety
- need to cannulate
- need for escort
- amnesia
- must have reversal drug - flumazenil
what is oral sedation?
- delivered as a drink
- usually midazolam
- less common than IHS or IV
- NOT the same as pre med
- must still cannulate for safety
what drugs do we use in sedation?
diazepam - pre med
temazepam - alternative pre med
midazolam - conscious sedation
flumazenil - reversal agent
