Conscious sedation

Different sedation techniques depending on patient’s needs:
  1. Oral premedication (OP) with anxiolytic medication eg. diazepam
  2. Oral sedation (OS) with sedative medication diazepam, temazepam, midazolam
  3. Transmucosal:  intranasal/buccal pre-sedation with anxiolytic/sedative medication midazolam
  4. Inhalation sedation (IHS) with mixture of nitrous oxide and oxigen (laughing gas, happy gas, relative anaesthesia, N2O/O2)
  5. Intravenous sedation (IV) with sedative medication: Midazolam, Propofol, Ketamine (?)
  6. Combinations of above: eg. OP + IHS, OP + IHS intranasal sedation, OP + intravenous sedation, IHS + IV (?)

 

Standards fo Conscious Sedation

 

Prevalence of Type of Sedation (Clinical Audit, Cumbria, SAAD Diggest Vol 32, Jan 2016): Intranasal: 0.5%, RA’s 63%, IVs 36.5%

Percentage of patients require any form of sedation ? according to literature: 10-20%, including general anaesthesia

 Conscious Dental Sedation Essentials

  •  Proper referral pro-forma
  • Dental assessment, radiographs
  • Medical history checked
  • Treatment plan
  • Options for pain and control given
  • Conscious sedation technique chosen
  • Valid consent
  • Pre and postoperative instruction given
  • Check list done
  • Sedation procedure
  • Clinical records includind dose, time, etc.