Intravenous sedation – analgosedation

Inhalation and intravenous sedation

Sedation – analgosedation basic information

Intravenous sedation (analgosedation) is aimed at calming the patient and reducing their anxiety during dental surgery. Performed only by a team of anaesthesiologists (doctor and assistant), analgosedation is a supplement to local anaesthesia. It involves intravenous administration of analgesics and sedatives as well as continuous monitoring of the patient. Analgosedation makes it possible to keep the patient in a state of limited consciousness, without the need for general anaesthesia, which improves safety.

Sedation is a procedure that provides the patient with a complete lack of pain, stress and anxiety and short-term memory loss (i.e., the patient does not remember the procedure).

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Indications and contraindications for intravenous sedation

Indications

The indications for sedation include:

  • dentophobia – fear of dental surgery
  • long surgical procedures
  • strong gag reflex
  • nervous hyperactivity
  • chronic diseases requiring the presence of an anaesthesiologist during the procedure
  • treatments requiring intravenous administration of antibiotics and anti-swelling drugs

Contraindications

Strict:
Non-compliance with the requirement to fast before the procedure is a strict contraindication
Relative:

  • pregnant women
  • patients with uncontrolled diabetes
  • patients with renal and hepatic insufficiency
  • patients with decompensated hyperthyroidism
  • patients using psychoactive substances
  • patients with advanced respiratory diseases such as asthma, emphysema, bronchiectasis

In any situation of relative contraindication, sedation is possible, but requires special preparation.

Preparation for intravenous sedation

In order to prepare for the sedation procedure, the patient must remain on an empty stomach, i.e. six hours without a meal and four hours without drinking fluids. The patient should also be in good general condition and without infection (cough, runny nose, fever). If you are being treated for chronic diseases, it is advisable to provide the relevant information cards from the course of treatment.

The course of intravenous sedation

Sedation is performed by a team of anaesthesiologists, who provide the patient the medication intravenously, because in this way it is easier to control. As a rule, short-acting drugs are administered so that the patient can function independently shortly after the procedure.

During sedation, despite the use of drugs acting on the central nervous system, the patient stays awake all the time and is in verbal contact with the doctor. The patient is in a state of deep sedation, often combined with shallow sleep. Their movements are slowed and they do not feel any fear or anxiety.

After the procedure

After the sedation, the patient can return home, but the presence of an accompanying person is recommended. They should not drive motor vehicles themselves or use machines or mechanical devices. They cannot make any important life decisions.

Inhalation sedation

Inhalation sedation basic information

Stress before dental procedures can eventually turn into dentophobia and discourage dental treatment, even for life. Inhalation sedation using a mixture of gases (nitrous oxide and oxygen) is a safe and pleasant method that makes it possible to forget the fear of treatment. This method is widely accepted and embraced with enthusiasm by patients who are concerned about dental visits. Inhalation sedation induces a state of physical relaxation and pleasant bewilderment, while maintaining the patient’s awareness and basic reflexes. The patient responds to the doctor’s orders and is able to speak, although their awareness may be partially limited. The inhalation sedation system stands out for providing the safety, reliability and ease of use needed for stress-free treatment for both the patient and the doctor.

How does the body react to nitrous oxide?

  • possible slight tingling of the tongue or fingers
  • reduced fear and anxiety
  • the patient’s awareness is maintained (the patient is able to keep their mouth open by themselves)
  • the cough reflex is preserved
  • visual and verbal contact is maintained (though may be delayed)
  • possible greater sensitivity to sounds
  • dreams may occur

Device for inhalation sedation

Master Flux Plus is the only sedation device that has been completely developed and manufactured in Italy. All parts are manufactured by Tecno Gaz and are subject to meticulous, individual inspection, thanks to which it has the medical CE certificates. Master Flux is a Class A medical device.

Indications and contraindications for inhalation sedation

Indications

Inhalation sedation can be used for everyone, but there are certain types of patients who will be the most beneficial. These are patients:

  • sensitive to pain
  • with a strong gag reflex
  • children and adults with nervous hyperactivity
  • children and adults experiencing strong fear of treatment (dentophobia)

Contraindications:

Inhalation sedation, like practically every treatment, also has its contraindications, which include:

  • upper respiratory tract infections, hypertrophy of the tonsils, cold
  • lung diseases
  • first trimester of pregnancy
  • mental illness and taking strong medications used to treat mental illness
  • drug addiction
  • alcoholism (including treated alcoholism – it may return after the procedure)
  • multiple sclerosis, porphyria, myasthenia gravis
  • heart defect
  • consumption of a meal immediately before the procedure
  • lack of cooperation on the part of the patient

Preparation for inhalation sedation with nitrous oxide

  • do not eat for at least 2 hours and preferably 3 hours before the treatment
  • children must be looked after by an adult – either a parent or legal guardian
  • no alcohol consumption on the day of surgery

After the procedure

According to the literature, the patient may drive motor vehicles 30 minutes from the end of the procedure, however, for the sake of safety of our patients, we recommend that they do not drive at all on the day of sedation.

Frequently asked questions

Should milk teeth be treated?

Yes, milk teeth should be treated just like permanent teeth. The consequences of untreated cavities might be dangerous for a child’s health.

Are there any contraindications for inhalation sedation?

Yes, the most common contraindication is a cold, hypertrophy of the tonsils, or acute sinusitis, and thus the obstruction of the upper respiratory tract. Sedation should also not be used in patients in the first trimester of pregnancy. Other contraindications for sedation are: mental illness, multiple sclerosis, porphyria, myasthenia gravis, bronchial bronchiectasis, emphysema, otitis media, cochlear implant or alcoholism.

How long does inhalation sedation last?

The administration of nitrous oxide may last as long as required by the given procedure. The gas remains in operation for approx. 15 minutes after the end of administration. After this time, the patient regains full consciousness.