Conscious Sedation
Our anesthesiologist will undertake the conscious sedation exercise for comfortably undertaking the dental procedures. It is normally used in performing complex dental procedures such as implant surgery, root canal operation, tooth extraction, and veneer placement. Besides these, it can be used on patients who are generally afraid about visiting dentists, have a very bad gag reflex, or cannot sit quietly in the dentist’s chair. It is also necessary while operating on mentally disabled patients or if the local anesthesia is not working for some reason.
The experienced anesthesiologist will determine the extent of sedation and the drug used depending on the better judgment of several factors. This includes the length of the purported procedure, the pain threshold, and the age of the patient. Conscious sedation effectively transpires the patient to a semi-sleep state where you may remember only a part of the dental procedure.
Depending on the extent and type of sedation, the effect may wear off in one hour or a few hours. In some cases of mild sedation, patients should be able to drive themselves home. However, for optimum safety, it is always recommended to have someone drive you home after the procedure.
Preparation stage
1. Obtaining patient consent: Valid informed consent about conscious sedation should be obtained in writing. For pediatric dentistry, consent must be provided by the legal guardian.
2. Detailed checkup: We will check your entire medical history to determine your eligibility for the sedation process. Conscious sedation outside the hospital environment should be applied only to patients who come under Grades I and II according to the American Society of Anesthesiologists (ASA) classifications. A detailed examination of the airway is done for pediatric patients to look for any kind of anatomical airway abnormalities. For patients with underlying medical or surgical conditions, a concerned specialist is concerned before administering conscious sedation.
3. Pre-sedation fasting: In some situations, the patient may be asked to undergo fasting in the preparatory stage to prevent the risk of any loss of protective airway reflexes.
Challenges of conscious sedation
Our experienced anesthesiologist would remain ready to handle all possible challenges. These include:
- Phobia and anxiety
- Dentist and anesthesiologist working at the same time
- Presence of co-existing medical conditions such as mental instability, epilepsy, and cardiac anomalies
- Chances of arrhythmias due to trigeminal nerve simulation during surgery
- Enlarged tonsils and adenoids, especially in children
- Risk of the patient losing full consciousness or getting into cardiovascular and respiratory depression
- Risk of vasovagal syncope due to the dependent position of legs in the dentist’s chair
Conscious sedation setup
We undertake all precautions to make it safe. The anesthesiologist will be present throughout the procedure to observe the condition of the patient. Monitoring equipment such as the ECG, pulse oximeter, NIBP, ETCO2, and Defibrillator is kept within reach and in working conditions.
A crash cart consisting of emergency resuscitation equipment and drugs is kept handy during the entire procedure. The conscious sedation procedure is carried on only after ensuring the availability of adequate oxygen supply, functioning flow-meter & tubing for oxygen delivery, and the right-sized airway equipment.