Is Propofol safe for IV sedation? ---- Can't tolerate other sedatives

[Camisa]

I can not tolerate benzodiazepine sedatives (aka benzos) such as Versed/midazolam, HAlcion/triazolam, Valium/diazepam, etc.

Unfortunately they seem to be the only "safe" methods of sedation significant enough to help me with my extreme unease with a surgical extraction of tooth #2. (I have been waiting to see an OS).

Is Propofol safe, as an alternative to the benzodiazepines?

And since I am hypersensitive to almost all drugs, is it possible to try and explain to my OS and his team that I wish not to have other medications in my IV?

Having an IV hooked into my bloodstream to me is a severe feeling of a loss of control, especially since the administration of painkillers and benzos have adverse effects on me, and antiinflammmatories like steroids often give me seizures.

I have had Propofol during MAC anesthesia for an endoscopy a few years ago so I don't believe I had any adverse reactions to it but I hate the fact that so many places like to throw a lot of drugs into the "cocktail."

I just need to be still and unaware so that the procedure can be carried out ---- what I don't need is to have serious reactions to drugs.

Can anyone please advise?? I'm at my wit's end; miserable....

Thank you so much for listening to me,
Andrea

 

[Gordon]

Yes it's safe, but it's not ideal, the margin between sedation and unconsciousness is quite narrow. For those reasons I'll only use it in a hospital environment and with a second person doing the sedation.

 

[Camisa]

Thank you for your reply. When you say hospital setting, would that include an oral surgeon's office which specislizes is so-called "sleep dentistry?" My OS is a "special needs" OS and has over ten Anesthesiologists come into his office, while two Dentist-Anesthesiologists work there every day.... although I'm not sure of its accreditation and there are no surgical technicians.

But they often use "anesthesia-based dentistry" with the help of these Anesthesiologists and I am assuming they do it in the office... could it still be safe in an outpatient setting?

Also how do I discourage them from using polypharmacy on me? I don't believe I need painkillers and steroids and whatever else in my IV, the risk outweighs the benefit for me because I will take a little pain/discomfort over hypersensitivity reactions to medications.

Thanks so, so much!

Andrea

 

[Gordon]

GA for dentistry in the UK must be performed in a hospital with an Intensive Care Unit on the site. Because it's relatively easy for propofol to slide over from sedation into GA, then here in the UK, I can only use it in the hospital.

The regulations for GA are a lot different in the US, if the OS's practice is set up for GA, then I can't see a problem with using propofol in that setting.

As for the polypharmacy bit, that should be fairly straight forward, you have to give your consent for treatment, if you specifically insist not to have anything other than IV propofol, then that should be that. If not your lawyers will have a field day.