Intravenous Dental Sedation (IV)-Risks And Benefits

‘Intravenous Sedation’, also known as ‘IV sedation’ refers to the type of dental sedation in which a sedation drug is administered into the blood stream through a vein. During this type of Sedation, patients remain conscious and are able to actively respond to stimulations.

Drugs Used In IV Sedation

The most common drugs used for Intravenous Sedation include; Benzodiazepines (Benzos), Opioids and Barbiturates.

·      Benzodiazepines

Benzodiazepines or Benzos including Diazepam and Midazolam are most commonly used for Intravenous Sedation. These are anti anxiety drugs and work in three ways;

  1. Reduce anxiety and help in relaxation
  2. Make patients drowsy, and
  3. Produce total or partial amnesia (patients do not remember the dental procedure).

·      Opioids

Opioids are strong pain killers that are mostly used to maximize the effect of Barbiturates or Benzodiazepines. However, these drugs are mostly recommended to be used to relieve post treatment pain. The administration of an Opiod is also recommended in cases when the patient remains un-sedated even after the administration of the maximum dose of Benzodiazepines. Opioids used for Intravenous sedation include; Morphine, Meperidine, Butorphanol, Fentanyl, Pentazocine, and Nalbuphine.

·      Barbiturates:

Barbiturates are sleep inducing drugs that are no longer used for IV sedation in the United States. The only drug from the Barbiturate family that is still used occasionally is Pentobarbital Sodium. These drugs are recommended to be administered in the presence of a trained Dental anesthesiologist; otherwise they can be very dangerous. The risks involved in using these drugs include;

  1. Slipping of patients into general anesthesia (by mistake), and
  2. Lowering of heart rate and breathing rate thus increasing the risk of coma death.
  3. These drugs do not have a reversal agent

The only advantage these drugs have over Benzos is their ability sedate patients for a longer period of time.

·      Propofol:

Some dentists prefer to use Propofol instead of Benzos. These drugs have a quick recovery time and must be constantly administered into the blood stream during a dental treatment. The dosage rate is selected by the dentist. The drug is classified as a ‘General Anesthesia’ drug and is recommended to be used only in a proper hospital setting. These drugs can prove to be of help to sedate patients who have developed a high tolerance for Benzos.

Is Intravenous Seduction a Safe Procedure?

IV or Intravenous Sedation is an extremely safe procedure if it is carried out under the supervision of a qualified and trained dentist. The DSTG (Dental Sedation Teachers Group) use the following classification to decide if IV sedation is safe to be administered or not.

  1. A normal, healthy patient
  2. A patient with mild systemic disorder like mild asthma, controlled diabetes, etc.
  3. A patient with severe systemic disorder such as uncontrolled high BP, fresh heart attack, etc.
  4. A patient with a permanent or temporary disability such as a bedridden or hospitalized patient.
  5. An extremely vulnerable patient.

Benefits of Intravenous Sedation

The main advantages of IV sedation are as follows;

  • IV is a very effective method of sedation as the procedure works rapidly and the dosage of drugs and the sedation level can be modified very easily to meet the needs of different individuals.
  • In comparison to oral seduction, IV sedation is a highly reliable and effective procedure.
  • Unlike General anesthesia or deep level sedation, patients are conscious during the treatment in IV sedation and can actively respond to stimulations.

Risks Associated With Intravenous Sedation

The risks associated with IV sedation are as follows,

  • Some patients may experience mild complications like hematoma (a localized swelling filled with blood.
  • The recovery time is relatively longer in comparison to other sedation options.
  • If your dental procedure is carried out by a trained dentist there are no real risks associated with IV sedation.

Larry Davis wrote this article on behalf of leading Las Vegas Dentist Dr. Stephen Delisle.