Is IV sedation safe for people with dysautonomia / POTS?

[archstanton]

I have severe dental phobia and only have work done under IV sedation. So far all my procedures have gone well.

Recently, my doctor suspects that I may have some form of dysautonomia like POTS. My main symptom is tachycardia. For which I take a beta blocker (metoprolol).

I need some dental work done and my dentist is concerned about using IV sedation given my health situation.

I think he uses midazolam, dexmedetomidine, and fentanyl.

I am having seven fillings 12, 13, 14, 15, 18, 29, and 30 (Is that too many to do at once?)

If the IV sedation is not suitable. The only other option would be nitrous oxide (which I've never had before) or maybe oral sedation.

I realize that this is a special circumstance and you may not be able to answer the question accurately or at all, but just thought I'd try.

I was just wondering if any of the dentists here or patients have had any experience with this?

Thanks

 

[Gordon]

Shouldn't be an issue with just Midazolam. I've never used a drug cocktail like you describe for IV sedation, so I couldn't comment on that, but just straight up Midazolam, no problem. Assuming your tachycardia is well controlled before your appointment.

No idea regarding the amount of fillings, depends on too many factors I don't know about.

If IV sedation is out then Oral sedation would be a far worse option. You have so little control of the way the drugs are absorbed that it would be very risky IMO.

 

[archstanton]

1. The only way to control my tachycardia would be to take a beta blocker. Metoprolol Tartrate 12.5 mg or 25 mg. Would this interact with the Midazolam?

2. As for the fillings, my treatment plan is as follows: 12 B, 13 B, 14 OL, 15 OL, 18 B5, 29 DB, 30 DO

3. Also, I would need a local anesthetic without epinephrine, like Carbocaine (Mepivacaine).

4. You didn't mention nitrous oxide, so I'm guessing that would not really be a viable option.

 

[Gordon]

1. No.

2. The amount of work needing to be done is just one factor, I really can't comment on whether the number of fillings is doable in one visit or not, sorry.

3. Not an issue, there are plenty out there.

4. No, it would be a viable option for many people. I only mentioned oral sedation as being a very poor option in most cases.