Pharmacology

CONSIOUS SEDATION

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Conscious Sedation

Conscious sedation is a level of CNS depression where a patient does not lose consciousness but is able to communicate and cooperate during the procedure/treatment.

Indications

•Uncooperative patients.

• Anxious patients.

• Emotionally compromised patients.

Conscious sedation should be avoided in:

• Chronic obstructive pulmonary disease.

• Pregnancy

• Prolonged surgery.

• Psychoses

Drugs used

Drugs used

  1. Benzodiazepines
  • Diazepam is the most commonly used drug for conscious sedation.
  • Small doses (1-2 mg) of diazepam is administered intravenously slowly. It can also be administered orally.
  • Midazolam is a short-acting BZD given intravenously. Temazepam is given orally. It is safe and has better patient compliance.
  1. Nitrous oxide + oxygen: Nitrous oxide is given by inhalation route along with 100% oxygen.
  1. Propofol( i.v. infusion), fentanyl (i.v.), etc. can also be used for conscious sedation.

Precautions

• Written informed consent should be obtained from the patient prior to the procedure.

• Conscious sedation should be administered by trained personnel.

• Constant monitoring of the vital signs should be done during and after the procedure.

• The procedure should be documented. Postoperative instructions should be in written form.

• Equipment and emergency drugs should be kept ready to tackle any emergency • Patient should be escorted by an attendant.

Source- textbook of pharmacology for dental students – Tara V Shanbhag

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