Intravenous sedation is a modern, safe, predictable and effective way to reduce anxiety in patients. It makes potentially stressful procedures more pleasant for you.
Who will sedate me?
Tim Milton administers all intravenous sedation at the Bath Oral Surgery Clinic. He has extensive experience in providing intravenous sedation, in both hospital and practice environments.
Tim is assisted by a nurse trained in the care and monitoring of patients receiving treatment under intravenous sedation.
What is the sedative?
A single sedative is used called midazolam. It is a member of the benzodiazepine group of drugs and is the main agent recommended for use in intravenous sedation in the UK.
Midazolam is well suited for intravenous sedation as it brings about a general state of relaxation. The recovery period is smooth and quite short, with no feelings of nausea.
How does it feel to be sedated?
You will feel very relaxed and possibly sleepy, with a general sense of detachment from what is going on.
During your operation, you stay conscious, so you do not lose vital protective reflexes (such as the ability to cough).
After your operation, you are likely to have little or no recollection of having the treatment carried out.
How is the sedative given?
The sedative is given through a small plastic tube (a ‘cannula’) put into a vein on the back of your hand or inside your elbow. The insertion of the cannula is very quick and simple.
The sedative is given in small amounts over a period of time until you are sufficiently sedated for the operation to begin.
You will be monitored from the start of the procedure by our nurses who have specific and recognised training in the care of patients receiving treatment under sedation. Medical monitoring equipment is used to record your pulse, blood pressure, blood oxygen levels, breathing rate and end-of-breath carbon dioxide levels throughout your treatment as well as during the recovery period.
What happens after I am sedated?
A local anaesthetic is still needed to numb the area of surgery. This is given slowly and carefully before your operation begins.
After your operation, a recovery period is necessary during which the immediate effects of the sedation start to wear off. Your monitoring will be continued during this time. All relevant postoperative instructions (including any prescribed medicines) will be discussed with your escort.
When we are satisfied that you have recovered enough, you will be discharged home in your escort’s care.
How long does the sedation last?
This depends on the operation you need.
We aim to keep the sedation at a satisfactory level for the duration of your operation. You will only be discharged home when you have recovered enough from the sedation.
The effects of the sedative will be present for the next 24 hours, so it is essential that you follow our postoperative instructions.
Are there any risks involved?
The administration of any drug carries some risk. The risks associated with intravenous sedation as described are very small and can involve:
General lethargy in the 24 hour period following the procedure.
Amnesia starting from the time of the initial administration of midazolam.
Bruising developing at the cannula site.
Sensitivity/allergic reaction developing following the administration of midazolam.
Most sedation-related complications can be minimized by following our pre- and postoperative instructions. A very small number of patients are not suitable for treatment under intravenous sedation for medical reasons.
How does sedation compare with general anaesthesia?
Intravenous sedation is a form of ‘conscious sedation’ as, unlike general anaesthesia, the aim is not to bring about a complete loss of consciousness (including loss of protective reflexes). General anaesthesia can now only be administered in a hospital setting.
Intravenous sedation is inherently a more pleasant way of having potentially stressful treatment carried out. It is especially good if you are apprehensive, as the sedative’s action actually removes anxiety and so makes treatment much more comfortable.
Before your operation
You must ensure that you will be accompanied to your appointment by a responsible adult who will escort you home after your operation and look after you or arrange for you to be looked after for the following 24 hours. Please do not bring any children with you.
Do not eat or drink anything for three hours before your appointment time. Before this you should only have a light, non-fatty meal.
Do not drink alcohol on the day of your operation.
Do give us details of any changes to your medical history or daily medications.
Do continue to take all routine medications (including inhalers) at the usual times unless you have been specifically advised otherwise.
Do let us know if you feel unwell before your appointment as illness can affect your treatment.
Do wear loose-fitting and comfortable clothing with sleeves that can easily be pulled up beyond your elbows and flat shoes.
Do ensure that your fingernails are free from varnish or any additions.
Do clean your teeth thoroughly before coming in for your operation.
After your operation
Your escort should take you home by private car rather than public transport.
Rest for a few hours at home and take the rest of the day quietly.
Eat light and easily digestible food for the rest of the day.
Take any medicines that have been prescribed for you.
For 24 hours after receiving intravenous sedation:
Do not drive any vehicle, operate any machinery or use any domestic appliance.
Do not drink alcohol.
Do not return to work, make any important decisions or sign any legal documents.
Do not be in charge of others (eg, children and dependents).
Do take care when using the internet for personal communication or online shopping.
You’re in safe hands
Tim Milton is a member of Society for the Advancement of Anaesthesia in Dentistry and follows the guidelines of good practice set out by this organisation.
Find out how to help bring about a quick recovery after an operation.