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IV Sedation Fears

Aurora10

Aurora10

Well-known member
Joined
Feb 9, 2017
Messages
324
Location
Canada
Hi everyone. I would really appreciate support from anyone who is willing!
I have had IV sedation twice before, last year in fact, and it was really amazing-I had no problems at all. Well I did have a couple of very unpleasant nightmares after a couple of weeks but that could be coincidence.
I have a phobia about taking meds, I hate them and i distrust them. Probably due to my allergy to penicillin and an anaphylactic reaction to food once, it's developed into an intense dislike of even tylenol.
I have to have 2 crowns and a small filling at the end of this month under sedation and I can't believe it myself but I'm anxious again. I am scared of having an allergic reaction, even of dying while undergoing the procedure. I know that's irrational honestly I do, but it's starting to fill my head every day.
I keep wondering if I should just get at least the filling done in just with LA but I have had trouble getting numb in the past and I'm scared that I will have a panic attack if I keep having to have more and more injections, as that's what happened last year before I gave in and had IV sedation.

I dont like the fact that they use fentanyl in the IV, as well as midozolam, it just frightens me.
Can anyone give me some reassuring words of wisdom? I feel a fool for being anxious even after I've had great experiences with IV both times...
 
Pretty sure they can just do midazolam by itself. Especially for crowns. Not a dentist but I know I've had it before for procedures with and without other drugs. Do you feel comfortable asking your dentist if it's possible to only use midazolam?
 
Pretty sure they can just do midazolam by itself. Especially for crowns. Not a dentist but I know I've had it before for procedures with and without other drugs. Do you feel comfortable asking your dentist if it's possible to only use midazolam?

Hi Mugz! Thanks for sharing your thoughts on this. I don't know if they would do it with just that; I did talk to my dentist when I first decided to go for sedation and you know, asked him lots of questions about the procedure. I asked him about the safety margin with using 2 drugs instead of 1 and he said that using the 2 enables them to use less of both so that it's actually safer. But I think I will ask and see what they say about it, maybe they would just use the midozolam?
Do you live in N. America? You say you've had midozolam with and without orger drugs? Can you tell me more about that and what difference it made-and which way if doing things did you prefer?
Thanks so much!
 
Hi Aurora,

sorry to read about how much you worry and there is certainly nothing silly about that! Given your past experiences I do not even think this is an irrational fear. As far as I know, in US (not sure how about in Canada) using multiple drugs for sedation is the standard, while in Europe they only use midazolam. It sounds (from you other post) that you had fentanyl and midazolam together during your last sedation as well so there is hardly any chance of you being allergic to it. As with any fears, the best way is to talk to your dental team and ask lots of questions. Maybe they can do a kind of test to find out / demonstrate to you that you are not allergic. Maybe getting some information (from your dentists, not internet etc.) about how exactly the drugs work might help. Also how about asking them about the level of monitoring that will be provided and what will they be doing to make sure you will be fine?

Again, do not feel like a fool for having anxiety, surely every member will confirm that we all struggle with pre-appointment anxieties, even after we have made good experiences in the past. By the way, after having an anaphylactic reaction to food I can only imagine that your fear is stronger than two successful experiences with sedation. Our unconscious mind works really slowly and we need many many positive experiences to slowllet go of deep seated issues.

Hang on there, feel free to vent as much as you like and do keep us posted (and if I haven't said that before, it's lovely to hear of you again:)
 
Aurora

I can see how after having the previous experience with midazolam and fentanyl you would be cautious. I had a certain type of GA years ago and fainted after and always ask to make sure they will not give me that same type. well they barely do it, so never had it mentioned again.. I think it is sooo true what Enarete says about having many positive experiences to slowly let go of bad past experiences and issues.. this is so true.. That being said.. I can say, I've had the mix of Fentanyl and midzolem on like 4 different occasions and they have all went smoothly with no side effects other than being very tired on the way home a time or two.
 
Aurora

I can see how after having the previous experience with midazolam and fentanyl you would be cautious. I had a certain type of GA years ago and fainted after and always ask to make sure they will not give me that same type. well they barely do it, so never had it mentioned again.. I think it is sooo true what Enarete says about having many positive experiences to slowly let go of bad past experiences and issues.. this is so true.. That being said.. I can say, I've had the mix of Fentanyl and midzolem on like 4 different occasions and they have all went smoothly with no side effects other than being very tired on the way home a time or two.

Sorry for the late reply, I have been away for a few days. Thank you so much, you are always so kind and nurturing and I am grateful for it! I have come to the conclusion that it is probably natural to be a little apprehensive about going through this again, for me anyway. So I'm trying to keep busy and turn those catastrophic thoughts away and keep grounded in reality. ??
 
Hi Aurora,

sorry to read about how much you worry and there is certainly nothing silly about that! Given your past experiences I do not even think this is an irrational fear. As far as I know, in US (not sure how about in Canada) using multiple drugs for sedation is the standard, while in Europe they only use midazolam. It sounds (from you other post) that you had fentanyl and midazolam together during your last sedation as well so there is hardly any chance of you being allergic to it. As with any fears, the best way is to talk to your dental team and ask lots of questions. Maybe they can do a kind of test to find out / demonstrate to you that you are not allergic. Maybe getting some information (from your dentists, not internet etc.) about how exactly the drugs work might help. Also how about asking them about the level of monitoring that will be provided and what will they be doing to make sure you will be fine?

Again, do not feel like a fool for having anxiety, surely every member will confirm that we all struggle with pre-appointment anxieties, even after we have made good experiences in the past. By the way, after having an anaphylactic reaction to food I can only imagine that your fear is stronger than two successful experiences with sedation. Our unconscious mind works really slowly and we need many many positive experiences to slowllet go of deep seated issues.

Hang on there, feel free to vent as much as you like and do keep us posted (and if I haven't said that before, it's lovely to hear of you again:)

Thank you so much for great advice, I really appreciate it. I went to see the dentist who will be doing the procedure on the 30th, he's not my usual dentist but he's got a good reputation in the office and my dentist is away for holidays.
He was lovely and friendly, and listened to my concerns and answered everything. The drugs they use are the 2 you mention, you are correct. I read about the UK not using two different types of drugs and this was for and/or safety concerns and also because the level of training is higher over here apparently. My dentist told me that when these two drugs are used, the levels needed are lower than with just midozolam and that is why they mix the two. My practice thankfully takes a lot of precautions, even ones they dont need to by law-they health screen each patient and they have a paramedic start the IV and they are present in the room all the way to the end of the appointment, which most offices don't do and they have a heart monitor etc. So I know they are doing all they can to put the patient first. It's not even that expensive.
You are absolutely right, I have had no allergic reaction whatsoever with these drugs and the chances are small that I would become allergic in the future. But I like the way you explain how the mind holds on to negative experiences, so true!
I have to have this work done, there's a good way to manage it with sedation so I just want to think on just how good it was and that it really was a 'no-event event'. I have to have invisalign after this work is complete, as my jaw became misaligned after my bridge was placed, so there is quite a journey still ahead and I need to be strong. You and other friends here make it all easier to bear however so thank you ???
 
It's 3 days to my appointment and I've been feeling all kinds of emotions. One minute I'm happy and grateful to be getting the work done and the next I'm thinking catastrophic thoughts.
I read through my journal on here and was comforted by how I felt after both sedation experiences but I'm not feeling totally comfortable at the thought of it still.
Maybe I shouldn't expect to? Maybe that's just human nature, especially with anxious individuals or those going through a highly stressful time in their lives, which probably explains a lot about why I am feeling this way.
I am more afraid of afterwards than anything else. Having suffered a few panic attacks this past year, I just worry I'm going to have them after my procedure. I also worry that I will have breathing problems or a rash or something else weird-I confess I have been on Google again...
I wish so much that I could just walk away from this appointment but I know I have to go through with it or I will just get worse than I am now...
 
I believe it‘s ok to feel whatever you feel and expect whatever you do. It is not easy to take control of the own emotions or thoughts when experiencing anxiety so why not just accepting all the feelings that are there knowing that you will get the treatment done anyway?

Having an emotion doesn‘t mean there is a reason for it to be. I can feel like having offended someone while this wasn‘t the case or feeling guilty despite not having done anything wrong. In the same way it is possible to have anxiety while there actually is nothing to worry about. In my experience separating those things helps. Imagine this scenario: you are having a terrible flu, just want to stay home and go to bed, you feel awful. But you are giving that presentation that you just can‘t cancel. So what will you do? Accept the flu, do whatever you can to be able to stand there for that one hour giving your speech and then go to bed. You will know that the circumstances are not ideal and will be aware of the physical suffering that is there but you won‘t really believe to spoil the speech just because of that. So whenever I am experiencing anxiety, I just keep on saying to myself ‚it‘s just a flu‘.

As you say, it is a human nature to worry and have anxieties. For some it‘s flying, for some it‘s public speaking or going to a date and for some it‘s dental anxiety..

Keeping my fingers crossed for your treatment, I know you can do that.
 
Something to consider is everyone gives anesthesia a little differently from the amount, the drugs and how quickly. Their protocol is what they know best so unless you have a firm reason to request a change you may not want to. Please ask all your questions of them before though.
 
I believe it‘s ok to feel whatever you feel and expect whatever you do. It is not easy to take control of the own emotions or thoughts when experiencing anxiety so why not just accepting all the feelings that are there knowing that you will get the treatment done anyway?

Having an emotion doesn‘t mean there is a reason for it to be. I can feel like having offended someone while this wasn‘t the case or feeling guilty despite not having done anything wrong. In the same way it is possible to have anxiety while there actually is nothing to worry about. In my experience separating those things helps. Imagine this scenario: you are having a terrible flu, just want to stay home and go to bed, you feel awful. But you are giving that presentation that you just can‘t cancel. So what will you do? Accept the flu, do whatever you can to be able to stand there for that one hour giving your speech and then go to bed. You will know that the circumstances are not ideal and will be aware of the physical suffering that is there but you won‘t really believe to spoil the speech just because of that. So whenever I am experiencing anxiety, I just keep on saying to myself ‚it‘s just a flu‘.

As you say, it is a human nature to worry and have anxieties. For some it‘s flying, for some it‘s public speaking or going to a date and for some it‘s dental anxiety..

Keeping my fingers crossed for your treatment, I know you can do that.

So much good wisdom here, thank you friend! I agree with everything you say here, it makes so much sense.
I woke up.with a cold this morning and felt so happy that this might mean the procedure will have to be cancelled, and even felt I could go through with the treatment I need in several appointments. I do wish i could just have LA and not sedation but maybe I'm just setting myself up for failure?
 
Something to consider is everyone gives anesthesia a little differently from the amount, the drugs and how quickly. Their protocol is what they know best so unless you have a firm reason to request a change you may not want to. Please ask all your questions of them before though.

Something to consider is everyone gives anesthesia a little differently from the amount, the drugs and how quickly. Their protocol is what they know best so unless you have a firm reason to request a change you may not want to. Please ask all your questions of them before though.

Thank you for your advice. I asked for a meeting with the dentist a couple of weeks ago and he was very nice and empathetic. I also asked a couple of questions via email to the sedation co-ordinator and that was helpful.
The guys who start the IV and who are present throughout the procedure, monitoring the drug administration, are paramedics who work for STARS air ambulance. They're very experienced and very kind, and I'm sure they know what they're doing.
I can't help but wish I could just go without sedation though as I used to and it didn't bother me to get dental work done.
I think what I don't like is the fact that they use fentanyl, it just scares me frankly.
 
I’m surprised he doesn’t start his own ivs I presumed he received god training via a course rather than part of a residency. As to fentanyl there is a HUGE difference between taking something you think is heroin and taking a different drug of unknown concentration and full of other chemicals and garbage that was made illegally with no quality control in China or Mexico.
 
I’m surprised he doesn’t start his own ivs I presumed he received god training via a course rather than part of a residency. As to fentanyl there is a HUGE difference between taking something you think is heroin and taking a different drug of unknown concentration and full of other chemicals and garbage that was made illegally with no quality control in China or Mexico.

He and some of the other dentists did do a course wirh an IV school a couple of years ago. At that time they had a dental assistant to monitor the patient in addition to the assistant and of course, the dentist; in the room. The paramedic would start the IV's off and go back and forth between patients. Now though he stays with the patients the whole time.
Yes, they explained at the consult that the fentanyl they use is completely.different to street fentanyl. I think it's the fetanyl that makes me tired though and in other countries they believe it reduces the margin of safety, right? Maybe I'm just looking for reasons to worry unnecessarily.
 
Aurora10

I'm not of all the technical stuff, but what I can say is I've personally had the fentanyl /midzolam combo a few times for procedures with no complications and it went really smoothly. (I did not know anything about either before but only found out what it was after, however when I found out about a different drug on another procedure I had myself really worked up and very anxious and that ended up working beautifully as well) I hope it goes well for you . I lose track did you decide to do the sedation for sure or are also trying to see if someone might do local? whatever you decide I wish you the best.. and most comfortable , least bit of anxiety experience.
 
Aurora10

I'm not of all the technical stuff, but what I can say is I've personally had the fentanyl /midzolam combo a few times for procedures with no complications and it went really smoothly. (I did not know anything about either before but only found out what it was after, however when I found out about a different drug on another procedure I had myself really worked up and very anxious and that ended up working beautifully as well) I hope it goes well for you . I lose track did you decide to do the sedation for sure or are also trying to see if someone might do local? whatever you decide I wish you the best.. and most comfortable , least bit of anxiety experience.

Thanks so much, I do remember you mentioning that you'd had this combo in the past and it had worked well. I'm booked in for Friday so I guess it's easier to go through with it. I would like to get back to just having LA though.
A friend of mine just told me she takes Ativan for her appointments and it really takes all her anxiety away, I wonder if that would be something to try? Have you any experience with that that you could share?
 
I have taken Lorazepam before procedures and it just makes me chill , doesn't feel weird at all which I love , and Ativan once, but it wasn't in combo with the other drugs. so not sure how it would work in combo.
 
I have taken Lorazepam before procedures and it just makes me chill , doesn't feel weird at all which I love , and Ativan once, but it wasn't in combo with the other drugs. so not sure how it would work in combo.

Aren't lorazepam and ativan the same drug? That sounds good, so you still knew what was going on and felt no panic?
Yes, I was only meaning instead of using IV sedation, not as well as. Thanks!
 
I guess they are different brands of same thing . I've had Lorazepam prescribed more so feel very safe with it.. yeah knew exactly, I was just chill , relaxed .. depending on dose sometimes it makes you a bit tired. but I know the dose that works for me so just take that.. just a very comfortable feeling. though one time I had a blood transfusion , they gave me ativan and it calmed me really quickly and still knew what was going on. I really think they are pretty much same.

As far as using it for a substitute , personally I know it would be good for me to do the local plus lorazepam for most any dental procedure . I would definately talk to them about it if you want to try to see if it might work for you. Also.. my dentist was talking to me about a combo of lorazepam/nitrous and local.. which would really relax you if thats possible. never done that one before but sounded like an interesting option.
 
I guess they are different brands of same thing . I've had Lorazepam prescribed more so feel very safe with it.. yeah knew exactly, I was just chill , relaxed .. depending on dose sometimes it makes you a bit tired. but I know the dose that works for me so just take that.. just a very comfortable feeling. though one time I had a blood transfusion , they gave me ativan and it calmed me really quickly and still knew what was going on. I really think they are pretty much same.

As far as using it for a substitute , personally I know it would be good for me to do the local plus lorazepam for most any dental procedure . I would definately talk to them about it if you want to try to see if it might work for you. Also.. my dentist was talking to me about a combo of lorazepam/nitrous and local.. which would really relax you if thats possible. never done that one before but sounded like an interesting option.

That's really good information; thanks for explaining it all so well! I like the idea of not having any anxiety but knowing what is going on.
Did you ever consider having IV sedation instead of the lorazepam for dental work?
 
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