Is there a difference between UK IV sedation and US IV sedation? What drugs are used?

[daisychain]

Is there a difference between UK IV sedation and US IV sedation? What drugs are used?

Hi there so I'm from the UK but am staying in the US with friends. Unfortunately I developed a bad abscess on my upper right wisdom tooth and have scheduled an appointment to have the two upper ones extracted in the US by an oral surgeon on Tuesday.
I know it's expensive but I'm in so much pain and really do not have time to go back to the UK and try to scheduled there. I was happy when they offered IV sedation because I've had it in the UK before and it was great.
My main fear though is actually of allergic reactions to drugs, I've never had one myself by a close friend of mine passed away from one which makes me overly paranoid of the chances.
I've had both general and IV sedation with no problems or complications in the UK. Unfortunately my oral surgeon scared me on two fronts, he told me they probably use an entirely different drug in the US, and that he himself will be administering the anesthesia. (When I was in the UK I was in a hospital and had a separate anesthesiologist handling the sedation, while allowing the surgeon to do his work)
What kinds of drugs do they use in US sedation? Do they use multiple drugs vs one in the sedation? Do they have different effects from those used in the UK? Will I have a chance of an allergic reaction to these drugs? How common is this? I have no other allergies to drugs aside from erythromycin that I know of.
Also Is it normal for the dentist to also act as the anesthesiologist?

Thanks! Any advice/reassurance before Tuesday would be really appreciated as i've quite worked myself up into a state of unnecessary fear ;p

 

[brit]

Re: Is there a different between UK IV sedation and US IV sedation? What drugs are used?

Yes, there are differences. There's more info here:

https://www.dentalfearcentral.org/help/sedation-dentistry/

At the end of the day, you have to have confidence in the reputation of the person you allow to sedate you. In the UK I think the dentist can do the sedation and the treatment so long as a trained dental nurse is monitoring your vital signs. Many opt to have a separate anaethetist though.

As a layperson my impression is that you are safer with a separate anaesthetist in either country.

Is there no way you could do it with just nitrous and local anaesthetic if you are worried? How complex is it? If the tooth is already erupted, I doubt it would be horrendous to do a single tooth with local and nitrous (both very safe).

You could also ask what combination of drugs they plan to use - maybe even ask for just a single drug to be used as is the norm in UK (benzos).

 

[daisychain]

Re: Is there a difference between UK IV sedation and US IV sedation? What drugs are used?

Thanks for the fast reply Brit! The link really helped me, I guess the US does use multiple drugs in their sedation.

The reason for the IV is that A) i'd like to have no memory of the procedure whatsoever, and two apparently the extraction will be complex as they are going to have to break the tooth up into 4 pieces and remove some bone. Also to further complicate things some of the upper right tooth root is poking ever so slightly into my sinus which apparently is going to leave a small hole in my mouth to my sinus after the surgery is done.

However with all this said I did get a good feeling from this surgeon, he also does a lot of complex maxillofacial procedures (and is the only person to offer these in the entire area).

I think I'm going to stick with it and hope for the best. The only other dentist I consulted in the area was a local chap who offered to pull them all out for the bargain price of $300, he told me he didn't even need to take an x-ray.
I said great and when I asked what type of anesthetic he would use he said none. He told me he pops them out on a day to day basis and can get one out within minuets. (I left looking for other options and found my current surgeon )

Anyway the surgery itself is taking place in his office inside the hospital as opposed to a lone office, so I assume if anything did go wrong help would be close at hand?

 

[mango]

Re: Is there a difference between UK IV sedation and US IV sedation? What drugs are used?

re: Also Is it normal for the dentist to also act as the anesthesiologist?

I'm in the UK and have had IV sedation several times administered by just the dentist in his surgery. I got the impression that this was fairly routine for patients like me and I had full confidence in him and his nurse. This was also done on the NHS

 

[Pianimo]

Re: Is there a difference between UK IV sedation and US IV sedation? What drugs are used?

Also Is it normal for the dentist to also act as the anesthesiologist?

This seems to be normal in the UK - from my own experience with two different dentists (at different practices), from the websites of every other practice offering IV sedation that I researched (which is quite a few!), and also going by the tales of a number of other posters on here.

I was sure I could remember reading a thread about this, when some of the 'resident' dentists on here chimed in about doing sedation themselves, but despite doing all the searches known to man just now (or so it felt! lol) I can't seem to locate it! Did find this, posted by Gordon: "there's no reason why the dentist can't do the sedation, once the patient is adequately sedated...then there's really nothing that can't be monitored by an appropriately trained and qualified assistant." Hope that reassures you a bit.

I really feel for you having to have this done while you're away - not exactly part of the plan, I'm sure! Hope it goes well.

 

[daisychain]

Re: Is there a difference between UK IV sedation and US IV sedation? What drugs are used?

thanks guys, you've really helped <3 i'll let you know how it goes tomorrow if i'm awake enough lol

 

[Pianimo]

Re: Is there a difference between UK IV sedation and US IV sedation? What drugs are used?

All the best for today - hope it goes well.

 

[daisychain]

Re: Is there a difference between UK IV sedation and US IV sedation? What drugs are used?

All the best for today - hope it goes well.

heya, so I am back! Surgery went well, didn't feel any pain during the procedure , doctor and nurses were extremely helpful, whole extraction only lasted under 30 mins. Woke up with no memory and no pain, they did use polydrug in the IV, they used Versed which is the american name for medizaolm (sp?) or whatever they most commonly use in the uk. He also used an anti inflammatory drug.

Several hours later don't even need over the counter meds as there is no mouth pain. However one weird side effect i have experienced all day is pain in both my lower legs. At first i thought maybe it was from over movement while i was sedated. So I rang the doctor and honestly he says he has no idea, leg pain is obviously not a side effect of mouth surgery. He also promised me they never once had to hold down my legs or anything. So now i just sit here with a painless non swollen mouth wondering what is going on with my legs lol! has anyone experienced this?
Hopefully i'll just sleep it off and they will feel less achey.

thanks for all the advice guys!
xoxoxox

 

[daisychain]

Re: Is there a difference between UK IV sedation and US IV sedation? What drugs are used?

it must of been something related to the drugs/sedation because after sleeping it off my legs feel fine!
so in other words everything went 100% fine! yay!

 

[Pianimo]

Re: Is there a difference between UK IV sedation and US IV sedation? What drugs are used?

Hi Daisychain,

So pleased to hear it went well! I've read your story in the Success Stories section too - it's always great to read such positive posts!

With your legs, it's only a guess, but all I can think of is that perhaps you were laying in a way which made your legs stiff/achey, and you didn't notice or didn't care, because of the sedation. I got an achey neck during/after one appointment from the way I was laying, and I think if I'd been fully 'with it' I would have moved and got comfortable etc, but because I was sedated, instead I just lay in the same position for ages. Anyway, no matter now, seeing as your pain's gone!

so in other words everything went 100% fine! yay!

100% fine - can't get better than that!