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CONSCIOUS SEDATION (MODERATE SEDATION) by – DR. RAJAT SACHDEVA A technique that relaxes you during the procedure and leaves you with little or no memory of the experience afterwards.
What is Conscious Sedation? • A minimally depressed level of consciousness, that retains patient’s ability to maintain an airway independently and respond appropriately to physical stimulation and verbal command. • It is a combination of medicines to help you relax (a sedative) and to block pain (an anaesthetic) during a medical or dental procedure. • It lets you recover quickly and return to your everyday activities soon after your procedure.
Why the Procedure is Performed? • Conscious sedation is safe and effective for people who need minor surgery or a procedure to diagnose a condition.
Aims & Objectives : • Guard the patient’s safety and welfare • Minimize physical discomfort and pain • Control anxiety, minimize psychological trauma • Control behavior and movement to allow the safe completion of the procedure • These goals can best be achieved by selecting the lowest dose of drug with the highest therapeutic index for the procedure.
Candidates for conscious sedation • Infants that are at least 6 weeks old and were full term (>38 weeks) • Premature infants whose chronological age + gestation age is greater than 52 weeks • Healthy infants not meeting these criteria may be candidates, but MUST be monitored a minimum of 12 hours without apnea post procedure to qualify for discharge
Indications for Conscious Sedation • Dental anxiety and phobia • Prolonged or traumatic dental procedures • Medical conditions potentially aggravated by stress • Medical conditions affecting the patient’s ability to cooperate • Special needs
Common agents employed • GASES- Nitrous Oxide (N2O) & Oxygen (O2) • ANTIHISTAMINES • BENZODIAZEPINES & ITS ANTAGONIST • SEDATIVE HYPNOTICS • NARCOTICS & ITS ANTAGONIST
Conscious Sedation for Apprehensive Paediatric patients • Inhalation Sedation • Nitrous oxide/oxygen is usually the technique of choice for conscious sedation of paediatric dental patients • Intravenous Sedation • Intravenous sedation for children is appropriate in a minority of cases. • If practical, a topical anaesthetic should be used prior to venous cannulation.
AFTER CARE • Recovery Recovery from sedation is a progressive step-down from completion of treatment, through to the patient’s discharge into the care of a responsible adult escort. • Discharge All patients must be individually assessed for their suitability for discharge and should be allowed to leave only when they have returned to a normal level of responsiveness and orientation for age and mental status and can walk unaided (if appropriate).
PRE AND POST-OPERATIVE INSTRUCTIONS FOR PATIENT • Intravenous, Oral and Transmucosal Sedation • Patients should eat normally on the day of their appointment and must avoid alcoholic drinks. • Patients should take routine medication as normal unless advised not to by the treating dentist or anaesthetist
For the remainder of the day, patients must not: • - return to work; • - drive a car or other vehicle; • - consume alcohol; • - operate machinery (including kitchen equipment); • - climb heights (e.g. ladders, scaffolding); • - be in charge of other people; • - make important decisions (e.g. signing legal documents).
RISKS: • Conscious sedation is usually safe. However, if you are given too much of the medicine, problems with your breathing may occur. A health care provider will be watching you during the whole procedure. • Conscious Sedation that is carefully planned and carried out by a thoughtful, well-trained health care team will allow both caregivers and patients to have a positive experience rather than a bad memory…
I 101, Ashok Vihar Phase 1, Delhi- 110052 • Contact us at • Phone : +919818894041,01142464041 • Our Websites: • www.sachdevadentalcare.com • www.dentalimplantindia.co.in • www.dentalclinicindelhi.com • www.dentalcoursesdelhi.com • Google+ link: https://goo.gl/vqAmvr • Facebook link: https://goo.gl/tui98A • Youtube link: https://goo.gl/mk7jfm • Linkedin link: https://goo.gl/PrPgpB • Slideshare link:http://goo.gl/0HY6ep • Twitter Page: https://goo.gl/tohkcI • Instagram page: https://goo.gl/OOGVig