Wisdom teeth IV sedation in US - terrified

[jenarloa]

I'm in the US. I have a wisdom tooth that is horizontal impacted with a cyst, oral surgeon wants to take this one out and do a bone graft and also remove the other horizontal one.

I have never had sedation before and one of the OS I consulted with wanted to do deep sedation (which terrified me as it's so close to General Anesthesia) so I'm getting another consult tomorrow.

Is it at all possible to get this done with just local? Or a light IV sedation, if sedation is absolutely necessary? Is there such a thing as light IV sedation?

What drugs do they use in the US? I'm a light weight and don't drink or have ever had a Tylenol with codeine or anything stronger than a regular tylenol. I'm afraid they're going to give me too much sedation and I will stop breathing, or I'll have a reaction. This is giving me panic attacks and I cannot function or sleep. Please help!

I attached the xray

 

[Gordon]

Is it at all possible to get this done with just local? Or a light IV sedation, if sedation is absolutely necessary? Is there such a thing as light IV sedation?

Yes, but you'd need to get them done one at a time, it's not great to freeze both sides of the lower jaw at the same time. IV sedation can be as light as the anaesthetist/patient wants, you have total control over the level of sedation.

What drugs do they use in the US? I'm a light weight and don't drink or have ever had a Tylenol with codeine or anything stronger than a regular tylenol. I'm afraid they're going to give me too much sedation and I will stop breathing, or I'll have a reaction. This is giving me panic attacks and I cannot function or sleep. Please help!

Most IV sedation is done with Midazolam, which is one of the safest drugs in existence, (as far as I know there has never been an allergic reaction to it) and the margin of safety is phenomenally high, you almost can't inject enough of it to overdose an adult.

 

[jenarloa]

@Gordon thank you! In the US I think they use a bit more drugs to get deep sedation. That's what I'm panicked about.
You said only one side under local though, do you know why that is? Won't they still use local to pull both even with IV sedation, leaving both side numb anyways?

 

[Gordon]

One side at a time. Basically the LA makes half the tongue numb as well as the tooth, so you don't really want somebody wandering around with a totally numb tongue for 3-4 hours, there's a high risk of trauma due to biting it...

Occasionally in the US they used to put a narcotic in with the Midazolam but that's pretty frowned on nowadays.

 

[jenarloa]

Thank you! I was under the impression they put a whole bunch of stuff in your IV (propofol, fentanyl, etc). It makes me feel better that they usually don't.

 

[jenarloa]

Just wanted to follow up! I did it. I prayed to Jesus the whole time and he got me through it. I remember them putting the meds in the IV, then I woke up in the chair. They wanted me to walk but I was a bit dizzy.
After an hour I could open my eyes without being dizzy while driving (we love far from the doctor). I'm home recovering now. I panicked for days for nothing. God had me the whole time.

 

[jenarloa]

Oh and the drugs they used, I was completely coherent by the time I left the office. ,

 

[Gordon]

Well done on getting through it and thanks for the update.

IV sedation is great. DO you remember much about the journey home? Some folks do, a lot more don't.

 

[jenarloa]

@Gordon yes I do. I remember the 60 minute ride. I know where I was and what I said. I just didn't want to open my eyes.

 

[krlovesherkids777]

@jenarloa

Just wanted to say glad it went well for you and you are through it with a good experience! HOpe you heal up well and quick.

 

[jenarloa]

Thank you!