Patient Information Prior to IV Sedation
Midazolam (Versed) and Triazolam (Halcion) are medications that can greatly minimize anxiety that may be associated with going to the dentist. In a relaxed state, you will still be able to communicate with the dentist while treatment is being performed. If desired we can induce a sleep-like state of consciousness where you are still able to respond to us but will not likely remember the dental treatment. Even though it is safe, effective, and wears off rapidly after the dental visit, you should be aware of some important precautions and considerations. The following are a few common questions and important points that will help to ensure a safe and comfortable experience.
Can I eat before being sedated? To ensure your safety you should not eat or drink anything for the 6 hours prior to being sedated. Avoid heavy meals 10 hours prior to being sedated. If you have medications that you normally take it is usually okay to take your medications with a few sips of water on your regular medication schedule, but this must be discussed with the doctor in advance. Also, to prevent dehydration you should drink a lot of water the day prior to the sedation and drink plenty of water right up to 6 hours before the procedure.
Will I need someone to drive me home? Yes. And because the sedation will affect your balance, coordination and judgment for a number of hours after the procedure you will need an escort to not just drive you home, but stay with you until you are recovered later that day.
Will I remember the procedure? Often the medications used to sedate you will cause an amnesia that will result in your not recalling the procedure itself or any instructions given to you afterwards for a few hours until the medications wear off. It is important that you and the doctor have discussed the planned treatment and that you have consented to the planned treatment as well as reasonably expected alternative treatment measures which may be needed before being sedated. Also, that your escort be given the post-operative instructions to relate to you after the medications wear off. It is not uncommon for your escort to need to repeat things to you because you forgot conversations due to the effects of the medication for the hours following sedation.
What should I wear to the appointment? Because we will be placing monitoring devices on your arms you should dress in layers over a short sleeve shirt. Warm loose fitting pants and comfortable shoes (with flat soles) will also help to ensure your comfort and make it easier for you to walk when the medications have affected your balance. To keep you warm and comfortable during the procedure we will provide warm blankets and neck pillows.
How long will I be out? It depends on the length of your treatment procedure, but once the procedure is complete the medications will generally wear off to the point where you are stable and ready to be escorted home within 30 minutes, but the amnesic effects may last for hours after the procedure.
What if I have to use the restroom during the procedure? You will be encouraged to use the restroom immediately prior to starting the procedure, but if you express the need to relieve yourself during the procedure you will be escorted by one of our team members to the restroom. Although it is very rare, in case you relieve yourself during the procedure it would be wise to have your escort pack a change of clothes for you. If you have a history of incontinence make sure you are properly prepared with the appropriate undergarments.
Will the IV hurt? We use a small gauge needle to administer the medications (smaller than what is typically used for blood test draws by your physician) and we use topical anesthetic to minimize the pinch you feel from the needle as well as take all measures possible to keep the experience as quick and pain free as possible. After the initial injection the needle is removed leaving only the thin, soft, flexible rubber catheter so you can move without risk of injury, however we will loosely secure your arm so that you do not accidentally tangle or dislodge the medication line. After the procedure patients sometimes experience soreness or bruising at the injection site.
How will I let my escort know when to pick me up? When we schedule the appointment we will give you a time window that your escort should expect to be here by and request your escort’s contact information. The day of the procedure as the doctor gets close to being finished with the treatment a team member from our office will call your escort and instruct them where to park to facilitate your transport. If you and your escort have utilized our valet parking service plan to have your escort get the car first and park at the corner just outside our office. Once your escort is parked outside ready for you one of our team members will escort you down to meet them curbside and deliver any important homecare instructions to your escort after you are safely buckled into your vehicle.
Will the sedation medications react with my regular medications? Tell the doctor if you are taking the following medications as they can adversely interact with Midazolam (Versed) and Diazepam (Valium): nefazodone (Serzone); cimetidine (Tagmet, Tagment HB, Novacimetine, or Peptol); levodopa (Dopar or Larodopa for Parkinson’s disease; antihistamines (such as Benedryl and Tavist); verapamil (Calan); diltiazem (Cardizem); erythromycin and the azole antimycotics (Nizoral, Biaxin or Sporanox); HIV drugs indinavir and melfinovir; and alcohol. Of course, taking recreational/illicit drugs can also cause untoward reactions. To make sure we get you comfortably sedated and cause you no harm you must disclose all recent alcohol consumption and current medications (taken within 48 hours) including prescription, over the counter and recreational drugs to the doctor.
What if I may be pregnant? If you even suspect you may be pregnant you should not receive sedation medications and before planning sedation you must confirm you are not pregnant. If you are not sure, take a home pregnancy test or check with your physician. The medications used for sedation can cause adverse pregnancy outcomes (birth defects, miscarriages, etc.) and must not be used when there is a question of pregnancy. Also these medications can be passed through breast milk so if you are breast feeding you are not a candidate for sedation.
What medical conditions would prevent safe sedation? If you are hypersensitive to benzodiazepines (Valium, Versed, etc.), if you are pregnant or breast feeding, if you have advanced liver or kidney disease or if you have narrow angle glaucoma it is not safe to use these medications to be sedated.
I have diabetes... if I do not eat for 6 hours before sedation should I take my insulin? If you are diabetic we will discuss your specific concerns and consult with your physician to determine the best way to maintain your health regarding your diet and medications prior to sedation.