Conscious Sedation

[brysdad]

What kind of dental work are you getting done for 5 hours?? That sounds miserable. I had a root canal done a couple of weeks ago, local anesthetic and about an hour later, I was good to go (but couldn’t move the left side of my face haha)

Two root canals and some fillings. Doesn’t sound like the full five hours will be “in the chair”. Y’all are kind of freaking me out! I was looking for folks who have had good experiences with sedation. Not really the whole you’re probably gonna die stuff!

[kae006]

Two root canals and some fillings. Doesn’t sound like the full five hours will be “in the chair”. Y’all are kind of freaking me out! I was looking for folks who have had good experiences with sedation. Not really the whole you’re probably gonna die stuff!

I had the pill when I had all 4 wisdom teeth removed. They said it wouldn’t make me fall asleep but that I wouldn’t remember any of it. They were right. I gotta wonder though, just because I didn’t remember does that mean it didn’t hurt?!

[nursejenn]

Nurse Jen could chime in on this more......but Respiratory Failure can occur due to the CO2 levels being too high. Oxygen levels may look fine and then failure occurs rapidly. It occurs because no one was watching the CO2 levels. Then they have to bag the Patient. I am not a Doctor but I did stay at a Holiday Inn once.....only once.

Ok, let me break it down best I can. In a normal (unsedated) person, increasing CO2 levels cause breathing. CO2 level goes up, you exhale and inhale (isn't it kind of amazing what your body does without you even thinking about it?). When you add sedatives to the mix, they actually depress the receptors that you to breathe (or breathe more/faster) when your CO2 rises. When that response is blocked (due to sedation/too much sedation), the person doesn't breathe in response to increasing CO2 and hence respiratory failure. This is why we monitor ETCO2 levels in moderate/conscious sedation rather than SPO2 because the ETCO2 is an earlier and better indicator of respiratory failure. ETCO2 is measured with every expiration of the patient whereas SPO2 is measured peripherally (like on a finger) and takes longer to show a problem on a monitor...

Not everyone has a problem with moderate sedation. Working in a trauma ER, I've been involved in ALOT sedations over the past 2 1/2 years and only once has RT had to bag one of my patients because she stopped breathing...


Now as for my personal experience with it... I had an emergent endoscopy this past July. I learned that I am a lightweight when it comes to sedation meds. When I woke up, the anesthesiologist told me I was out for almost an hour (for a 10 minute procedure) and they had to intubate me until I woke up enough.

-Highly Respected since 2014

[ByronB]

Two root canals and some fillings. Doesn’t sound like the full five hours will be “in the chair”. Y’all are kind of freaking me out! I was looking for folks who have had good experiences with sedation. Not really the whole you’re probably gonna die stuff!

LOL....You will be fine. No need to freak out. It will not hurt to know if they do ETCO2 monitoring though. The people who have not had good experiences are not here to ask. Does that make sense? Believe me, if I have to go in for a surgery I will be way more freaked out than you. I will ask them if they have this machine, that machine, which cannula, who is giving the sedation, are they qualified.....blah, blah, blah. You will be happy it is all done and will not remember much of it.

[8mpg]

Yikes!!!! Which department do you work in? Years ago I used to find “no monitoring” in a location or two in Hospitals. Found one in Austin. Endoscopy Dept.....however, all of the other departments were using ETCO2 cannulas. Then, if you visit an off-site Endoscopy Center I do not know of any that do not monitor. Most of the surgeries are 20-25 minutes. If someone is pushing Anesthesia Meds then the Patient should be monitored. Dental locations are less motivated to do it due to costs. However, I sell to a bunch of Oral Maxillofacial locations that monitor during each procedure. Nurse Jen could chime in on this more......but Respiratory Failure can occur due to the CO2 levels being too high. Oxygen levels may look fine and then failure occurs rapidly. It occurs because no one was watching the CO2 levels. Then they have to bag the Patient. I am not a Doctor but I did stay at a Holiday Inn once.....only once.

Oh, I know why we monitor it.. We do in lots of neuro patients in the ICU. I occasionally work in a procedural area in our hospital. If a case is longer, we will usually draw a gas. We are surrounded by anesthesia if something were to happen and the good old fail safe is bagging a patient. The ER I used to work in didnt do end tidal CO2 either, but again, in the ER, the MD can intubate if there were an emergency. If our case run over an hour, we are usually checking a blood gas.

[312InchMagnum]

I’m a dentist and consciously sedate patients on a regular basis. End tidal CO2 monitoring is becoming the trend in our world of conscious sedation. The tough thing about oral sedation is once the patient takes it you have virtually no control. We do however have a reversal agent for the most common drugs we use to sedate patients. Thankfully I’ve never had to use it. Also, everyone is so different as to how these meds affect them. Thorough medical history and patient interview is critical. Also, I look at the patients throat, listen to their lungs, do they have sleep apnea, etc? When every it is done correctly it’s very safe and effective. I usually mix a couple drugs together and sometimes even add nitrous oxide to the mix. That’s almost as good as IV sedation. Different drugs we use have different onsets and last different lengths. The length of the procedure depends on what we sedate with. For instance, versed is quit and potent, but doesn’t last long at all. My most common combination is Valium and halcion. Patients typically do excellent and experience amnesia so they don’t remember the details of the procedure. I’m sure you will do fine! Best of luck!


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[Mexico]

5 hours! just give me a bullet

[ByronB]

Oh, I know why we monitor it.. We do in lots of neuro patients in the ICU. I occasionally work in a procedural area in our hospital. If a case is longer, we will usually draw a gas. We are surrounded by anesthesia if something were to happen and the good old fail safe is bagging a patient. The ER I used to work in didnt do end tidal CO2 either, but again, in the ER, the MD can intubate if there were an emergency. If our case run over an hour, we are usually checking a blood gas.

My apologies.....I did not mean to suggest you personally did not know why monitoring needed to be done. That was for the masses. The other factor you mentioned is that you all do have the tools at your disposal.....possibly right down the hall if something goes awry.

[Brute Killer]

I had my hand operated on with just a nerve block applied in my upper arm.
I was conscious and my arm was strapped in place.
I was talking to the anesthetist and I guess I started squirming around or something and they knocked me out.

[Uncle Saggy]

Conscious sedation? I do that every weekend.

Nice !!!!!


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[johnpaul]

I had this done for the first time the other day for a cervical epidural steroid injection. They put my on the table and I was talking to the nurses, next thing I know I’m waking back up in the pre op room. I was a little nervous but it made it easier knowing how much better I’d feel after the injection.

[bearintex]

5 hours in the chair? Knock me smooth the f out. My claustrophobia starts kicking in after about 20 minutes.

[Double-O-Dave]

I had my hand operated on with just a nerve block applied in my upper arm.
I was conscious and my arm was strapped in place.

I had the same thing done to me for hand surgery - it's known as a Bier Block. I recall periods of sleep interrupted by someone (loudly) snoring, as well as some very inappropriate jokes and comments made by the surgeon's staff. On a post-op visit with the surgeon, I mentioned I had hear many of the comments made during my procedure, and that I wasn't pleased with the lack of decorum in the OR. When I repeated verbatim some of the comments made during the procedure, he blushed, apologized, and said he would speak to his staff about this. A few years later, I needed surgery on the other hand and I found a different hand surgeon. BTW, I never experienced any pain during my procedure.

Regards,

Dave

[brysdad]

12 hours until game time. Pretty anxious at the moment, even with the pill they gave me to get a good nights sleep. Sho hope they can get me nice and sedated. I’m a big, high strung guy so we’ll see.

[kingranch]

https://m.youtube.com/watch?v=Tdqdemnh51o