Conscious Sedation

Question 1

What is conscious sedation?

GDC Definition

Answer 1

A technique in which the use of a drug or drugs produce a state of depression of the central nervous system enabling treatment to be carried out, but during which verbal contact with the patient is maintained throughout the period of sedation.

The drugs and techniques used to provide conscious sedation for dental treatment should carry a margin of safety wide enough to render unintended loss of consciousness unlikely.

The level of sedation must be such that the patient remains conscious, retains protective reflexes, and is able to understand and to respond to verbal commands.

Question 2

Describe briefly the ASA classification

Answer 2

ASA I:
* no organic, physiological, biochemical or psychiatric disturbance

ASA II:
* mild to moderate systemic distrubance
* mild diabetes
* moderate anaemia
* well-controlled asthma
* not disabling

ASA III:
* severe systemic disease
* severe diabetes with vascular complications
* severe pulmonary insuffieciency
* disabling

ASA IV:
* severe systemic disorders that are already life-threatening
* signs of cardiac insufficiencies

ASA V:
* moribund patient who has little chance of survival without operative intervention

Question 3

What are the complications of conscious sedation?

Answer 3

• respiratory depression
• nausea
• hypoxia
• hyperactivity
• unintentional loss of consciousness

Question 4

What are the contra-indications of nitrous oxide sedation?

inhalation conscious sedation

Answer 4

• multiple extractions, poor attenders and very young children
• common cold, tonsilitis, nasal blockage and bleomycin (chemotherapy)
• pre-cooperative children
• first trimester of pregnancy