Any IV Sedation Dentists on here?

[kcjacoby]

I need to ask a question about medication and dosing regarding IV sedation...

 

[Paige2018]

I am not a dentist, but if you post your question then other dentists will be able to see and post answers.
I hope you get the information that you are looking for!

 

[Gordon]

Ask away then, but be aware that answers may be fairly general.

 

[kcjacoby]

Alright, here we go. I'm a patient over in the US, more particularly in Michigan. This was a recent experience that I had with IV sedation.

I had a traumatic experience when I was a younger child, and now that I'm in my 40's, I'm suffering from not regularly visiting the dentist.

I found a dentist by me that does IV sedation. I signed up for the procedure with sedation.

Procedure day comes, they start trying to relax me with the gas, and insert the IV.

The doctor says that he's putting the medicine in, and that I should feel nice and relaxed.... so I wait for it to effect me... and then nothing happens.

I ask if they had put the medicine in yet... and they replied yes.

Again... I felt like nothing was different.

I mentioned to the dentist that "I really didn't feel as if anything had happened yet."

He said, "Well, you're a bigger guy... it might take a little more to get you totally comfortable." (160kg... I played football)

Okay... and then we waited. Another 20 minutes go by, and they put another dose into the IV. Still... nothing. ANOTHER 20 minutes... another dose... and I still could talk, interact, and be aware of everything going on. In fact the dentist buzzed a hand piece and I nearly jumped out of the chair...

They hit me with another dose, and I felt maybe a little something... but I was still there... and still not to where I wanted to be.

The dentist asked if I was okay for him to get started, and I objected because I was still very much aware of everything going on.

This continued on until the point where I believe I had been there almost 2 hours, and no work had been done yet. And I started asking questions. They told me that they are only able to give me a dose every 20 minutes, and that 'usually' other patients are already feeling the effects of the medication by now.

After all that, I do know that I felt relaxed between the combination of the gas and the medication... but I did not experience the 'amnesia' / time passing effect that it is touted to have.

After talking to the dentist about that... he said that there are rules and regulations regarding how much they are allowed to give at one time....

Would the fact of them having to spread it out over such a long time prevent the medication from ever 'fully' working on me?

Or do I honestly go down the rabbit hole and try to find a dentist that will do general anesthesia.... because we all know that it is just not cost effective to do so.

Thanks for listening to my rambling...

 

[Gordon]

It's hard to comment on your case in particular since I have no clue about what drugs were being used or what their technique was. Some idea of your previous medical history would be handy too.

Did they have any issues with getting the IV line started?

It might be that the line wasn't going into a vein properly and thus you were getting the drugs IM (intramuscularly) instead of IV (intravenously), which has much poorer uptake and a much slower onset.

Secondly, different people can have different results with different drugs, build/weight etc have less effect than you might think, the most difficult patient I ever sedated was about 5 stones and could soak the stuff up like a sponge. I've also done a huge Russian guy who was off his face in seconds

Dosing every 20 minutes is not something I'm familiar with, it's not a technique I ever heard of, but again, I don't know which drugs... my technique was 1mg Midazolam every minute till happy place for the patient was reached.

If you can get more information regarding which drugs were being used I could maybe be more help.