IV sedation

We use the Cambridge Intravenous Sedation Service.   From their literature, here is a complete guide to their services and what's involved should you be a candidate for IV sedation as part of your dental treatment here at Clinic 95.

ABOUT YOUR INTRAVENOUS SEDATION FOR DENTAL SURGERY

Your dentist has requested that you be considered for intravenous sedation either because you are very nervous, your dental procedure could be long and uncomfortable or you may have a pre-existing medical condition and would be safer being treated under sedation.

Intravenous sedation or 'conscious sedation' is achieved by using a mixture of drugs which will make you very sleepy and relaxed and may stop you from remembering anything about the procedure. It is NOT a general anaesthetic and you will NOT be unconscious. You will be able to speak to your dentist throughout the procedure, although you may not remember this.

These drugs will be injected into your bloodstream via a small cannula placed into a vein, generally on the back of your hand, secured in place by a clear dressing and will remain there until you are ready to go home with your escort.

Your dentist will give you a local anaesthetic injection into your gum prior to commencing your procedure, but you will also be receiving pain-killing drugs via the needle in your hand to prevent pain.

You may also be given oxygen to breathe throughout your procedure and this will be administered via a small spongy tube placed just inside the nostril.

RISKS FROM YOUR INTRAVENOUS SEDATION

Intravenous sedation or 'conscious sedation' is generally very safe. Your sedation is to be administered by a consultant anaesthetist with many years’ experience. His assistant is a registered general nurse (RGN) who has anaesthetic training too. Both your anaesthetist and anaesthetic nurse have had advanced life support training. You will be fully monitored by ECG, blood pressure, pulse and measurement of the amount of oxygen in your circulation. These observations will be carried out and recorded throughout your procedure and both the anaesthetist and his assistant will be with you at all times. They also have a full range of resuscitation equipment and oxygen.

However risks do exist, whilst these are usually temporary and associated with general anaesthesia, some of them may cause long term problems. We are required to provide you with as much information as possible before your procedure - INFORMED CONSENT - and so we have listed these below:

COMMON SIDE EFFECTS

• Nausea or vomiting
• Headache
• Pain or bruising at injection site
• Sore throat or throat and lips
• Blurred or double vision
• Itchy / sore nose

LESS COMMON SIDE EFFECTS

• Muscle aches and pains
• Weakness
• Mild allergic reaction – itching or rash

UNCOMMON SIDE EFFECTS

• Allergic reactions and/or asthma
• Blood clot in the leg
• Damage to nerves and pressure areas
• Epileptic seizures

RARE RISKS WHICH MAY CAUSE DEATH

• Severe allergy or shock
• Very high temperature
• Stroke or heart attack
• Vomit in the lungs
• Paralysis
• Blood clot in the lungs
• Brain Injury

INCREASED RISKS

These risks are increased in elderly patients and also by:

• A bad cold or flu, asthma or other chest disease
• Smoking
• Being overweight
• Diabetes
• Heart disease
• Kidney disease
• High blood pressure
• Other serious medical conditions

Remember, these side effects are usually minor and uncommon but have been included as a part of our requirement of providing you with informed consent.              

YOUR RESPONSIBILITIES PRIOR TO HAVING INTRAVENOUS SEDATION FOR YOUR DENTAL SURGERY

You are at less risk from your intravenous sedation prior to having your dental surgery if you observe the following:

• Increase your fitness – improve your blood circulation and lung health
• Give up smoking at least 6 weeks prior to surgery to help your lungs and heart improve. Let your dentist and anaesthetist know that you smoke
• Bring in your prescribed / herbal drugs. Report any allergies / side effects that you may have to any drugs
• Drink less alcohol – this may affect the way the sedative drugs work. DO NOT drink any alcohol for 24 hours prior to your sedation
• Stop taking recreational drugs – these may affect the way the sedative drugs work. If you have drug addiction please tell your dentist and anaesthetist
• If you take aspirin please tell your dentist and anaesthetist, this may affect your blood clotting mechanism
• If you take the contraceptive pill or may be pregnant please tell you dentist and anaesthetist

It is most important to inform your dentist and anaesthetist of any of the following:

• Health problems
• Infectious diseases
• Previous operations
• Serious illnesses
• False teeth
• Loose teeth
• Crowns (caps)
• Dentures
• Any medical problems needing regular treatment or stays in hospital
  

ON YOUR DAY OF SURGERY

You may eat food and drink up to 4 hours prior to your surgery.
You may then have clear fluids e.g. water up to 2 hours prior to your surgery.

For the last 2 hours prior to surgery you MUST NOT have anything to eat or drink at all. This includes chewing chewing gum or sucking lollies and is to ensure that your stomach is empty.  This reduces the risk of you vomiting under intravenous sedation and inhaling vomit into you lungs which is a potentially a life threatening condition.

You will only be able to proceed with your intravenous sedation if you have a responsible adult who will take you home at the end of the procedure (a taxi driver is not acceptable!) and who can stay with you for the next 24 hours.

Please wear appropriate loose fitting clothes - we will need access to your upper arms for our blood pressure monitor and your chest for the ECG.

Please do not wear lipstick or nail varnish on the day of surgery.

If these instructions are not followed your procedure will need to be delayed or even postponed.

RECOVERING FROM YOUR INTRAVENOUS SEDATION

The anaesthetist will give you a drug to reverse the effects of the sedation, he will ensure that you are pain free and treat any nausea or vomiting. He will observe you closely and your vital signs will continue to be monitored and recorded.
You will only be discharged from his care when you are fully alert, able to walk, have had a drink and he is satisfied with your condition and your vital signs are all within normal limits.
Only then will the needle be removed from the back of your hand and a small pressure dressing will be applied.
It is advisable for you to spend the rest of the day at home resting quietly in the care of a responsible adult escort.

THINGS TO AVOID AFTER YOUR INTRAVENOUS SEDATION

Intravenous sedation will affect your judgement for about 24 hours. During this time you MUST NOT:

• Drive any type of vehicle
• Operate machinery
• Climb ladders or work from heights
• Make any important decisions or sign a legal document
• Drink alcohol, take other mind-altering substances, or smoke. These may react with the sedative drugs
  

Please complete your pre-operative questionnaire as accurately as possible and return it to your dentist.

If you have any concerns or queries regarding this information please contact your dentist.