Blood pressure and IV sedation

[Loricarol]

I have pretty extreme medical anxiety in general, but anything having to do with dentistry puts me over the edge. I have to have tooth #2 extracted this week and have opted for IV sedation (they are using nitrous oxide, followed by Versed and Propofol).

To make things more stressful, I have pretty severe white coat syndrome when it comes to blood pressure. Readings at home on a verified device (two of them, actually), average around 123/70. In medical settings, it has gone up to 172/95. I expect it to be that or higher day of the procedure. My oral surgeon is sending me to get a pre-op physical with blood work because he won't operate if it is over 160 or 100. Naturally, I expect that my blood pressure for that physical will be through the roof too. I'm not sure what to do besides bring my blood pressure unit with me to show the doctor my historical readings.

What is the highest blood pressure you've accepted to proceed with IV sedation?

My other question is about the sedation itself. I want to be totally knocked out and unaware of anything that is happening. The surgeon says they use "moderate" sedation and I will be "very sleepy" but not out. I understand this is conscious sedation and I am technically somewhat conscious, but will I have any recollection of the procedure when it is done?

I had sodium pentathol 30 years ago for all 4 wisdom teeth and experienced nothing. As far as I know, I fell asleep and woke up seconds later. I'm hoping this is the same experience, but a complete nervous wreck. Thank you for reading this far!

 

[Gordon]

160 and 100, same as your OS. That's pretty much the standard guidance for IV sedation.
A pre-op anxiolytic like Temazepam would be worth considering to bring your BP into a more reasonable range.

I understand this is conscious sedation and I am technically somewhat conscious, but will I have any recollection of the procedure when it is done?

Most likely nothing at all, some people remember little fragments but mostly nothing. Plenty of anecdotes from people on here who have had it if you want to do some research.

 

[Loricarol]

Thank you for the feedback, Gordon.

I had the pre-op yesterday and the BP was 176/88 in the office. I brought my BP unit from home with my full history to the appointment so they could review it. They did an EKG and approved me for the procedure. Just to note how crazy this is, the BP was 116/68 when I got home.

Meanwhile, they found a heart murmur that they want to look into, but said it would have no bearing on the procedure (I'm pretty fit and run 20 miles a week without issue, so probably not a big deal..hopefully).

They gave me propranolol to take morning of. Not sure if that will do anything, but it is worth a shot.

I can't believe how nervous I am about this. I have built it up in my head to be an absolute nightmare situation. I hope the drugs kick in fast.