Intravenous sedation is administered into a vein, usually in the back of the hand or the arm. Intravenous sedation is also known as conscious sedation or moderate sedation.
It is an effective form of sedation with a high safety record and success rate. It is used for relieving anxiety and fear for nervous patients during medical and dental procedures. It will keep you calm, drowsy, at ease with having the treatment and will also, in most cases, make you forget all or almost all of what is going on around you. Due to this degree of amnesia (memory loss), most patients who have had intravenous conscious sedation think that they have been completely unconscious. This is, of course, not true, since general anaesthesia is no longer allowed outside of operating theatres in hospitals.
During sedation, the dentist will be able to communicate with you but you may not remember much or anything at all after the effects of the drugs wear off. Your vital signs like blood pressure, breathing and pulse will be monitored. Your protective reflexes, for example coughing and swallowing should still work efficiently.
Who can benefit from intravenous sedation?
- Patients with a moderate, high or very high anxiety
- Patients who undergo difficult procedures
- Patients who gag easily
Who is not suitable for intravenous dental sedation outside of a hospital setting?
- Pregnant women
- Patients with BMI >32
- Patients with complicated medical histories or patients who are taking certain medications
- Patients under the influence of alcohol or recreational drugs
Advantages and Disadvantages of intravenous sedation
- rapid onset
- good sedative effect
- good amnesia (useful when you do not want to remember the dental procedure)
- possibility of increasing the level of sedation in a controlled way
- possibility of maintaining the level of sedation for longer procedures by administering small amounts of sedative in a controlled way
- reduced risk of overdose compared to drugs taken orally
- generally faster and easier recovery compared to general anaesthesia
- generally fewer and less serious side effects postoperatively compared to general anaesthesia
- Possibility of reversal in case of emergencies. Reversal of sedation by using a reversal drug can only be done in some instances. Your dentist/sedationist can give you more information.
- Will need to use a vein to administer the drug. This can sometimes worry severely needle phobic patients even more.
Solution: Severely needle phobic patients can most of the time be treated either by distraction during insertion of the needle, by applying an anaesthetic cream on the injection site or by having gas and air sedation whilst the needle is inserted into the vein.
Important steps to follow if you want to have intravenous sedation
- Always give us a complete and accurate medical history
- Please follow fasting requirements on the day of sedation
- Please arrange for a responsible adult to take you to the surgery and back home (escort) preferably by car. The escort also needs to be able to look after you since you may be a little bit unsteady and forgetful.
- Please plan your day so as to avoid any activities which can be adversely affected by a decreased level of consciousness (see postoperative advice).