Sedatives are taken by patients to assist them to relax during medical procedures. The level of sedation that you intake determines the depth of relaxation that you get to. The levels of sedation are minimal, moderate, deep and general sedation.
In dentistry, sedation can be delivered in various ways;
• Through inhalation
• Oral sedation
• IV moderate sedation
• Deep sedation and general anesthesia
In this piece, more emphasis will be put on oral sedation; the definition, types, how it is performed, advantages and its disadvantages.
Oral sedation is a method of sedation where the drugs get administered orally. Oral sedation treatment is preferred by patients who have a fear of needles or those with general anxiety before medical procedures.
Types of Oral Sedatives
The most commonly used oral sedative is Valium (Diazepam). Others are Halcion, Ativan, Zeleplon, Visaril, Lorazepam and Versed. Each drug is used depending on the level of sedation that the doctor wishes to achieve for the drugs have different chemical compositions. For short procedures (about 1 hour), Zeleplon gets used. For moderately more extended procedures (1-2 hours), Halcion is the preferred benzodiazepine for use and the more prolonged procedures (2-4 hours), Lorazepam gets prescribed.
The medication drug is in the benzodiazepine family which means that it produces a calming effect to those who consume it. It boasts a longer half-life than many other oral sedation drugs. Valium can be consumed as a pill or in a liquid solution form. The effect of Valium takes about 40 minutes to materialize. The drug is commonly used where extensive dentistry procedures are being performed. It has a longer half-life than many other oral sedation drugs.
The drug is not recommended for pregnant women or lactating mothers should not be exposed to light or air and should not be stored in plastic containers.
The drug is majorly used for patients who require a short session of sleep of about 1.5 to 2 hours due to its short half life. Halcion is used to treat acute amnesia and other sleeping disorders. Triazolam is not recommended for children, pregnant women, and alcoholics.
Ativan is a benzodiazepine medication used to treat anxiety, sleeping disorders, seizures and in surgery to interfere with the memory formation of the patient and for sedation during an operation of a dental exercise. The drug is given 90-120 minutes before the procedure. People with allergies or that are hypersensitive to Ativan should not take it. Moreover, pregnant and breastfeeding women should avoid the drug too for it may have adverse effects on the child or the mother.
Majorly administered in liquid form. Versed can be taken as a premixed syrup or can be diluted before consumption. Many patients who do not like swallowing pills prefer Versed to Halcion.
How Oral Sedation gets administered.
First, the dentist has to be fully informed of the patient’s medical history. It is very significant for some patients may have some medical conditions which would result in serious side effects when they take the sedatives. The patient may also be taking some medications whose performance may be affected by the sedation.
When the doctor confirms that the patient can indeed receive sedation, the doctor should be able to determine the level of sedation that would be appropriate for the patient depending on the procedure that he is about to undertake. (If a patient is being sedated for the first time, it is vital that the doctor gives the patient the lowest dosage possible. After the procedure, the patient can describe the effect of the drug, and that can provide the doctor an insight to the dosage that is right for that patient.)
The doctor is supposed to explain to the patient about the risks involved in the procedure and the side effects of the sedatives once taken.
When all the above have been fulfilled, the doctor can now carry out the procedure with sterilized equipment and in a professional manner.
Factors that affect the sedation dosage.
Level of anxiety: Some patients may have significant discomfort right before an operation of a dental procedure. Such patients would require a stronger sedative so that they can relax throughout the process.
Medical History of the patient: A patient may have previous medical conditions that may be affected by the administration of the oral sedatives.
Age of the patient: Serious precautions should be taken when giving oral sedatives to seniors and young children.
The familiarity of the drug to the medical practitioner: A doctor, before administering any medication should be well aware of the substances in the sedative and its effect on the patient.
Weight of the patient
Convenient: Oral Sedation involves taking a pill which is quite easy for most patients.
Effectiveness: The pill once taken is quite useful for it requires just a small duration of time of about an hour to take effect. More to that, it delivers the amnesic impact needed.
Painless: There are no needles involved just swallowing of the medicine which does not induce pain to the patient.
Cheap: Compared to IV sedation, oral sedation is available at a lower cost.
Accepted by many patients: Many patients prefer oral Sedation
Some drugs may have severe side effects such as depression and withdrawal especially after long-term use of the sedatives.
Not suitable for patients with respiratory issues.
Not suitable for patients with higher levels of anxiety.
Apart from the benzodiazepine medications, antihistamines also get used as sedatives for short and even long procedures. However, the antihistamine drugs such as Diphenhydramine (Benadryl) can cause side effects such as dry mouth and are not recommended for patients with angle-closure glaucoma.
Sedation is indeed very significant in the medical field, especially in dentistry and surgery. Not everyone is qualified to give sedation procedures though; only professional medicals practitioners are supposed to administer the drugs. The purpose is to ensure that the correct assessment of the patient’s condition gets made, the appropriate prescriptions get appropriately issued.