Intravenous Conscious Sedation
Rohit is a current executive committee member of the New Zealand Society of Sedation in Dentistry, a member of the Society for Advancement of Anaesthesia in Dentistry in the UK and an international affiliate member of the American Society of Anesthesiology and the International Federation of Dental Anesthesiology Societies. He has a voracious appetite for knowledge and actively pursues continuing education in this field. He is heavily involved in education, research, consulting and teaching intravenous sedation to other dentists, surgeons and nurses both nationally and internationally.
What is it?
Let's face it. The dentist isn't exactly most peoples favourite place to visit. It is little wonder that the thought of having dental treatment can induce anxiety. Particularly, if the procedure is complex, long or if there are other factors that can make simple dental treatment seem challenging. For instance, if you feel claustrophobic while having treatment or have a particularly strong gagging reflex. Often people's perceptions are based on past adverse experiences.
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This is where sedation is a very useful adjunct. The purpose of sedation is to largely eliminate the significant and undesirable experiences of dental procedures by reducing or eliminating anxiety, apprehension, memory, and painful stresses sometimes associated with dental procedures. It even suppresses the gagging sensation and makes time appear to pass very quickly. Because sedation offers such a pleasant detachment from the procedure, most people feel like they have been asleep during the procedure. The goal is to make the treatment as comfortable as possible.
How does it work?
There are different sedative agents and techniques of administration. Rohit exclusively uses advanced intravenous sedation as his method of administration. This is the safest and most predictable approach as the medication is directly introduced into the blood stream through a small Intravenous cannula placed in a vein. This means the onset of the sedation is rapid as it does not have to pass through your stomach to get to your blood stream like an oral tablet would.
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Doing so allows us to have exceedingly precise control over the effects of the drug as we have already customised it for each individual patient and can move up or down the spectrum of sedation to make the process safe and comfortable. The recovery on stopping the medication is crisp and pleasant. Most patients have little to no recollection of the process.
Is it safe?
IV sedation has an excellent track record for safety in general. Furthermore, Rohit has undertaken additional and advanced training to be able to offer IV sedation in a more controlled and safe manner. He uses specialist anaesthetic technology to deliver a target controlled infusion (where the drug is constantly administered ensuring a balanced sedation). Your breathing, heart rate, blood pressure and even your brain waves are continuously monitored by us with the aid of machines to make sure that you are both comfortable and safe at all times. He also uses a mixture of short and ultra short acting drugs which run continuously but do not linger in your system for long once the sedation ends resulting in a rapid and sustained recovery.
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Your specific underlying medical conditions can have a bearing on sedation and this will be discussed during your IV consultation appointment in a thorough fashion to ensure this is the right option for you.
Want to know more? The stats for nerds.
The specific technique being used is BIS guided TCI sedation.
BIS stands for - bispectral index (BIS). The monitor is utilized to assess depth of sedation when administering sedative, hypnotic, or anesthetic agents. The depth of sedation is calculated by measuring cerebral electric activity via an electroencephalogram (EEG)
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TCI stands for Target Controlled Infusion. The "target" here is the concentration of the drug at the effect site (the brain) and is calculated using a computerised pump and a pharmacological formula for the specific drug being used which takes into account your height, weight, age and gender to individualise the drug administration.
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In addition to this, the monitoring equipment you may see on the day of your appointment includes but is not limited to -
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ECG (Electrocardiogram) to measure your hearts electrical activity
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Impedance based respiratory monitoring
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Capnography to monitor your breathing rate and quality
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Pulse Oximeter to monitor the oxygen content in your blood
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NIBP monitor to monitor your blood pressure non-invasively
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The more we know about you, the safer and more comfortable it gets! If you would like to know even more about the sedation process, ask Rohit at your consult and he would be more than happy to explain this to you further.