IV (Intravenous Sedation)
IV conscious sedation is a huge tool in our practice when we are helping a patient with moderate to severe anxiety with dental treatment. The procedure is very simple. Typically, we will give the patients a prescription to help them sleep better the night before the procedure and some light oral sedation an hour before the appointment to make sure our patient comes to the procedure more relaxed. Upon arrival, we will take all the necessary baseline vitals. A line will be started to deliver medicine directly in the blood stream, which takes 60-90 seconds before the patient begins to feel the medication. We will use a benzodiazepine in very low doses until the desired effect is achieved. The medicine normally lasts about 45 minutes before more medicine is needed or until the patient can be aroused for postoperative vitals to compare to preoperative vitals and dismissal procedures began.
How safe are the drugs you use?
In my 10 years experience with dental IV sedation, I have found in 95% of the cases, benzodiazepenes are my drug of choice. The medication is easy to titrate, doesn’t have to be used with a combination of drugs, which would slightly increase the risk of an adverse effect. It is not a CNS depressant which means you will not have to artificially breath for the patient as you do in general anesthesia. However, there are some contraindications, which include pregnancy, known allergy to benzodiazepines, alcohol intoxication, CNS depression, and some instances of glaucoma.
Is IV sedation dangerous?
We are very conscientious about the medicines we are using in IV sedation and we monitor the patient’s vitals throughout the procedure including heart rate, cardiac rhythms, pulse oximetry, capnography, blood pressure, and respirations. If any negative changes are observed, we can reverse the medicine almost immediately by adding a different medicine that blocks the effect. Because we have access with the IV, it is extremely safe and since it reduces your anxiety and stress which is dangerous in itself for patients who aren’t 100% healthy, it is safer for these patients than not being sedated for procedures.
Why do I need someone to drive me if I am doing IV sedation?
Are goal for patients is to eliminate or greatly reduce their fears with dental care. As we know the hours before the appointment can be as stressful as the procedures themselves, so we predicate the patient before they come. This reduces fears and helps with our goals. The medicine will impair your ability to drive and so it is imperative to have an escort drive you to and from the procedure.
How will I feel after my dental procedure with IV sedation?
Depending on the length of your procedure, the medicine we use will typically begin to wear off in about 45 minutes. The medicine will still be in your system for several hours and we expect you to go home and rest. You will not be allowed to drive for 24 hours and you will need someone to be with you in case you need anything. After the procedure and getting some food in their stomach, most patients will rest for a few hours and then feel back to normal that evening after a morning appointment.