Frequently Asked Questions:

Q. What Is Sedation

During the induction of general anesthesia, five distinct phases of consciousness had been described before the loss of consciousness actually takes place. In procedural sedation (PS), we make use of those phases and, by careful administration of medications, manipulate the level of consciousness to the point where the patient is awake and well sedated but the heart and breathing functions remain unaffected.

Various terms for procedural sedation are used; conscious sedation, sedation-analgesia, and MAC (Monitored Anesthesia Care).

Q. Where May Sedation Be Administered?

According the guidelines from all leading sedation societies in the world, sedation can be administered in an adequately equipped out-of-hospital treatment room such as a dental surgery or practitioner’s office; or in a hospital theatre or remote location within a hospital, i.e., endoscopy (gastroscopy/colonoscopy) or radiology suite. The American Society of Anesthesiologists makes it clear that the care provided and expected of sedation administered in a remote location has to be equal to the care provided in the in-hospital theatre setting.

Q. How Will My Sedation Practitioner Know About My Medical Background?

Prior to your sedation, you will be given a medical questionnaire to complete and sign. Please be as comprehensive as possible and provide as much detail as you can. No sedation practitioner can be held responsible for any issues you encounter as a direct result of pre-existing medical conditions that they are unaware of. Please bring along all medication you are currently taking and let us know whether you suffer from acid reflux or sleep apnea - this is very important.

Q.May I Continue To Take Herbal Medications?

Many of the commercially ‘innocent’ herbal drugs have anaesthetic implications, and some of these also affect the clotting of blood.

Two of those drugs need special attention: ST JOHNS WORT: this drug has an action similar to an older type of antidepressant and should be stopped at least one week prior to your procedure. This is very important! ARNICA: this drug is a blood thinner and can lead to haemorrhage (bleeding) into the wound and should be stopped one week prior to surgery. Should you have any doubt, please contact your surgeon to refer you to the sedationist.

Q.What About My Routine Medication?

The following are only guidelines, if you take:

BLOOD PRESSURE MEDICATION:
If your surgery will be performed in the afternoon, take all of your routine medication during the morning of surgery. If your surgery has been scheduled during a morning slot, please consult your sedation practitioner to discuss the medication you take.

ASTHMA MEDICATION: Continue with treatment and bring your inhalers along.

MEDICATION FOR DIABETES: For surgery scheduled in the afternoon, take your morning medication and have something to eat, all within the fasting guidelines. For surgery early morning, you will be fasting from the previous evening, so DO NOT TAKE YOUR DIABETES MEDICATION OR INJECTION as you will not be allowed to eat prior to surgery

Q.Will I Be Aware Of My Surroundings During My Sedation?

YES. The sedation practitioner will speak to you or tap your shoulder in order to verify your level of sedation. You should be conscious enough to respond to this - or they will need to adjust your level of sedation until it is just right. It is very important that you are aware of your surroundings.

Q. How Will Sedation Be Administered?

Sedation can be administered orally by inhalation, intravenously or a combination of those. The oral method sedation is typically administered as a tablet or syrup prior to the procedure. Inhalation sedation is the administration of Nitrous Oxide (laughing gas) for dental treatment. Intravenous sedation is administered through the vein, and unfortunately includes the placement of an intravenous cannula (drip).

Q. Is Memory Loss For The Period Of Sedation Common?

YES. One of the drugs used to reduce the stress levels during sedation is known to cause retrograde amnesia or temporary loss of memory. It is nothing to be concerned about.

Q. For How Long Do I Have To Be Nil-By-Mouth (Starved)?

As one of the complications of sedation is the inadvertent loss of consciousness, so you will need to prepare for full anaesthetic.

The following guidelines apply: SOLID FOODS and FLUIDS (all except water and Apple juice): 6 hours WATER and APPLE JUICE: 4 hours

Q. Are There Any Complications That I Should Be Aware Of?

As with all medical and dental treatment, there is always a risk. Risks may be forthcoming from your underlying medical condition/s, body habitus, recreational habits and allergies to the medications used. The biggest danger is inadvertent loss of consciousness; but our sedation practitioners have been trained to manage that. Other problems that could arise are double vision and headache - which normally subside after a night’s rest. Post sedation nausea and vomiting occur in less than 1% of patients.

Q. When May I Drive My Car Again?

It is advised that you do not drive a motorised vehicle, work with power tools or enter into any legal contracts with 24 hours.

Q. WHEN WILL I BE DISCHARGED?

Your discharge is according to a discharge scoring system used in all reputable sedation clinics. You will only be discharged into the care of a responsible adult after contact details have been exchanged and the discharge guidelines been agreed to.

Q. IS THE BILL FOR MY SEDATION INCLUDED IN THE ACCOUNT FROM THE CLINIC/SURGEON?

NO. All of the sedation practitioners are independent practitioners and you will receive a separate account for the sedation service. Please liaise with the sedation practitioner regarding the detail.

Q. WHAT HAPPENS IF I AM ALLERGIC TO ANESTHETIC AGENTS

Some people may think that they “are allergic to anaesthetics” because of previous unpleasant experiences such as nausea and vomiting. These are side-effects and not allergies. True allergies include swelling of the mouth, throat or eyes, breathing problems, hives and wheals, and sometimes a drop in blood pressure.

It is possible for a patient to show allergic reactions to some drugs, although it seldom happens. Allergy to latex is an increasing phenomenon, but seldom serious. If you suspect such an allergy you should inform your surgeon and sedationist in order to avoid rubber products being used. If any allergies occur, you will be tested after the operation so that those products can be avoided in future. You may have to wear a “medic-alert” bracelet.

Allergic reactions to one type of anaesthetic does not mean that you will not be able to receive anaesthetics in future.

Q. LESS SERIOUS SIDE-EFFECTS MAY INCLUDE

  • Dry mouth or temporary breathing problems
  • Itching, bruising or pain at the spot of injection
  • Rash due to plasters or medication
  • Sore neck, sore or dry eyes
  • Pain in arms or legs due to the positioning during the operation
  • You may also feel cold and shaky
  • These side-effects usually do not last long and do not need any treatment