Procedural sedation
What is procedural sedation and analgesia (PSA)?
It is the safe and effective technique of administration of medications that relive anxiety and reduce pain. The aim of PSA is to make the patient as comfottable as possible, whilst monitoring the patient continuously, so that the procedure can be completed ina completely save environment. You remain conscious but will be completely relaxed and pain free.
Not only is anxiety minimized, patients are back on their feet soon, without the long recovery period of general anaesthetic. The side effects experienced with PSA are much less than with general anaeathetic - very few patients experience any side effects at all.
Sedation dentistry generally uses specific, measured medications to help you relax during dental procedures. When you’re sedated, you’re generally awake but fully relaxed. No more fear, anxiety or outright panic during your dental procedures.
Frequently asked questions and answers
How does PSA differ from general anaesthetic?
PSA is a partial suppression of consciousness. The patient will feel relaxed, no recollection of the procedure, comfortable and some patients even sleep during the procedure. During PSA patients can be aroused verbally and will respond appropriately to questions and stimuli.
General anaesthetic is used in procedures where the anaesthetist totally suppresses the patient's consciousness. A general anaesthetic can only be done in hospital with the appropriate facilities.
Are you awake during sedation?
Different levels of sedation (mild, moderate and deep) are possible, depending on the type of procedure and the patient's preference. Under mild sedation the patient is awake, completely relaxed but can respond to questions of instructions. With moderate sedation, the patient may dose off but awakens easily. With deep sedation the patient will be asleep and only responds adter painful stimuli.
If I am conscious during the procedure, will I feel pain?
No. in most procedures done under prodedural sedation the administration of local anaesthetic will effectively block pain. The goal of PSA is to control anxiety and pain. The sedation practitioner will thus give you certain drugs to reduce pain during the procedure as well as drugs that will help with post-operative pain control. This in combination with the administration of the local anaesthetic will give you optimal pain relief during the procedure.
What does sedation feel like?
Sedation effects may vary to some extent from person to person; depending on the dosage and type you'll experience a calming effect, drowsiness, minor amnesia and tingling sensations. Within a couple of minutes you experience a full-body euphoria and pain breezes away while peace settles in.
How long does it take to "wake up" after the procedure?
The recovery time depends on the drugs used, the patient's individual response to the drugs and the time spent under sedation. During sedation your consciousness will never be totally suppressed as with a general anaesthetic - thus the term procedural sedation. Some patients are sleepier than others and some will even sleep through the procedure.
What side effects can occur after procedural sedation?
The side effects after procedural sedation are much less than with a general anaesthetic. Almost none of the patients experience nausea after the sedation. The incidence is only 0.7%
What can I do for the rest of the day?
You should be able to leave the aftercare after 15-45 minutes. You are however not allowed to drive yourself home. You will not be able to leave the dentists' room if there is not a responsible adult that can drive you home. For the rest of the day you are not allowed to sign any legally binding documents and you are not allowed to take part in any activities that require alertness or coordination (this is for at least 12 hours following treatment). You will not be able to return to work on the same day as the sedation. you should remain in the company of a responsible adult for 12 hours following the sedation.
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