Does IV sedation work for everyone?

[Petersj]

I would like some help in understanding why my IV sedation wasn’t effective. I went in for wisdom tooth removal yesterday, I opted for IV sedation as I was very anxious about it. I have no previous dental treatment so no trauma I guess but just the thought of it was awful and I wouldn’t have been able to do it under local. I took 10mg of diazepam the morning before as instructed. When I got there she gave me 1ml of midazolam at a time and I didn’t really feel anything. I was trying to do some deep breathing exercises to try and keep calm but I never felt fuzzy or drowsy in the slightest. They proceeded to do the extractions and I kept begging for more sedation because I was freaking out, I won’t go into too many details but I managed to finish the treatment but I remember all of it and I was not relaxed for any of it. Afterwards she said I had received 14mg of midazolam. She walked me to the car but I didn’t need her to because I felt completely normal on my feet, albeit traumatised and ready to get out of there. I didn’t feel anything amnesia and was more alert than when I went in. I don’t understand why it didn’t work and I don’t know why they went ahead even after me saying I wasn’t feeling sedated at all. How common is it that sedation doesn’t work and why me? I an a normal body weight, don’t do any illegal drugs, no alcohol and hadn’t taken anything other than the prescribed diazepam beforehand.

 

[Gordon]

Short answer is no, not for everybody
Longer answer: Response to any drug varies within a population from being very susceptible to not very susceptible at all with the vast majority being somewhere in the middle.

You might well be one of the group who are more resistant to the effects, it's rare but it can happen.

The other answer might be that the IV line has not been properly inserted into the vein and you've not really had the drug at all, it's gone into the tissues and will be absorbed very slowly, with negligible effects. Could be either.

I'm very surprised they went ahead under the circumstances, 14mg is not that high a dose they could've gone higher.

Body weight etc doesn't matter, the most resistant patient I ever had was all of 5 stones, about 4 foot ten tall and took 35mg without any visible effect!

There are ways around this for you, but it's something you need to discuss with whoever is doing the sedation.