Sedation

Sedation

Sedation is a procedure which involves the administration of sedatives; this procedure is commonly used in order to allow the health care professionals to perform certain medical procedures with application of local anesthesia. Sedation is commonly employed for such medical procedures as vasectomy, endoscopy, for minor surgery or for certain cosmetic reconstructive surgical procedures. In dentistry, it is used for the extraction of impacted teeth (generally wisdom teeth) and reconstructive surgery, as well as in the case of anxious patients. In dentistry, Sedation may be administered through inhalation (in such cases, the most common sedative agent used is Nitrous Oxide), oral or intra-venous administration.

This medical procedure is also very commonly used in the case of patients in intensive care, who are being intubated and artificially ventilated. Under these circumstances, the procedure is applied in order to increase the patients’ toleration of the endotracheal tube. There are several risks associated with Sedation. These include apnea, airway obstruction and hypotension, all of which are fairly common. As such, it is required that the patient is monitored by appropriately trained health care professionals, specialized in the detection and management of such complications, who will immediately intervene should any complications arise.

Patients may be sedated in various degrees, according to their medical condition and a number of certain other factors. This classification has been deemed in order to avoid administration of sedatives either in insufficient or excessive quantities. If under-sedated, a patient may still experience distress or pain, and the procedure is ineffective; on the other hand, if over-sedated, the patient is susceptible to severe complications – for example, they may experience breathing suppression, which may cause their death. The accepted classification for the various degrees is: agitation, calm, voice responsive, shaking responsive, pain responsive and non-responsive.

Of course, this medical procedure may also be applied whenever deemed necessary by the supervising health care professional. The decision to administer sedatives is usually based on the patient’s medical history and general health and emotional condition; this informational guide does not contain all the possible reasons for performing this procedure; if you seek to obtain additional details, it is strongly advised t hat you consult with a specialized health care professional.

Sedation Description

There are several types of Sedation which may be employed by the supervising health care professional. We will try to describe each of them in this chapter, in order to familiarize you with the procedures.

Some patients may not be able to relax or sit still during dental or surgical procedures; in such situations, the supervising health care professional may employ the use of conscious Sedation by administering medication which induces sleepiness or relaxation; the patient is still conscious and responds to stimulation and conversation, and none of the protective reflexes are suppressed. In order to perform this procedure, the physician may employ the use of inhaled sedatives, of oral sedatives or of sedative injections or intra-venous infusions. The exact procedure and sedative agent to be used will be determined by the supervising health care professional.

Nitrous Oxide (or laughing gas) is used with best results in the case of patients who are mildly nervous or anxious. Administration of this substance serves to ease the individual’s fears and allows them to relax. After administration of the sedative, the treatment may be performed safely and comfortably for the patient. Nitrous Oxide is administered with the aid of a face mask; the gas will be inhaled through the nose, and the sedative action can be observed as the patient becomes calm, although he or she is still fully conscious and able to converse with the physician. The effects wear off almost immediately after ceasing administration of the sedative.

For patients that manifest increased anxiousness, more potent sedatives may need to be employed. These are generally available under the form of tablets for oral intake, and in general their calming effect is significant. After ingesting a tablet of the chosen agent, the individual may become sleepy; he or she is able to respond to simple commands and also responds to stimuli.

Conscious Sedation may also be achieved through other means which are not extensively described in this chapter. The sedative agents may be administered by suppository, by inhalation, by injection or IV infusion; in general, these methods require advanced expertise in this area and the patient needs to be closely monitored.

Sedation Related Medication

There are several categories of medication which may be employed in order to induce Sedation. These include, but are not limited to barbiturates (for example, Amobarbital, Pentobarbital, Phenobarbital or Secobarbital) and benzodiazepines (including Clonazepam, Estazolam, Diazepam, Flunitrazepam, Lorazepam, Oxazepam, Midazolam, Triazolam, Nitrazepam, Alprazolam, Temazepam or Chlorsiazepoxide). Some health care professionals prefer to use non-benzodiazepine medication such as Zaleplon, Eszopiclone, Zopiclone and Zolpidem are included in this category. In some cases, the best option is the use of solvent sedatives (Ethyl alcohol, Diethyl ether, Methyl trichloride or Chloral hydrate).

Sedation may also be induced by using herbal preparations. Such substances are commonly based on ashwagandha, kava, mandrake, catnip, Ginseng, valerian and cannabis. Uncategorized sedatives are also usable – these include Clomethiazole, Thalidomide, Gamma-Hydroxybutyrate, Ketamine, Ethchlorvynol, Ramelteon, Glutethimide, Methyprylon or Methaqualone.

Barbiturates are substances derived from Barbituric acid, with depressant action on the central nervous system. This allows them to produce a number of effects including anesthesia and Sedation. Their action also makes them potent anxiolytic medicines, anticonvulsants and hypnotics. One of the most severe drawbacks is their addictive potential – both psychological and physical. In practice, this category of medication has been replaced by benzodiazepine class medicines, mainly due to the lower risks in case of overdose.

Benzodiazepine drugs are psychoactive products with various effects – they can be used as anxiolytics, anticonvulsants, hypnotics, sedatives and muscle relaxants, and they also possess amnesic properties. They may also cause physical addiction, and may trigger withdrawal syndrome after prolonged use.

The supervising health care professional will determine the appropriate sedative to use on an individual basis. You may discuss the options with the physician, and may consult him or another specialized health care provider (such as a pharmacist) regarding the medicine effects and adverse reactions.