What is Intravenous Sedation?

Most surgical procedures in our office will be done with the help of anesthetic medications that are delivered into the vein of the arm or the hand. Small catheters are placed after the skin has been numbed with a sprayed- on freezing compound. Intravenous anesthetic medications can be given for light sedation or for general anesthesia, depending on how they are given and how much medication is needed to safely accomplish the patient’s surgery comfortably. However, with the remarkable medications that are available today, the vast majority of our patients do not remember very much about the procedure. Many, in fact, really insist they were fully asleep when the goal was light intravenous sedation. The may have amnesia about the whole surgical event. Dr. Buche works hard to make sure the patient is appropriately sedated and comfortable. During general anesthesia, as one might need for having an appendix removed, the patient does not breath on his/her own normally and protective cough and swallowing reflexes are abolished. During intravenous sedation, and even what is known as “deep” intravenous sedation, these reflexes remain intact, although diminished. Patients will usually have little or no memory of the procedure with intravenous sedation. Along with sedative medications that cause amnesia and control discomfort, the patient is always given local anesthesia – it is rare for someone to remember when the novocaine, or xylocaine, is given. Because of the use of local anesthesia, patients will leave the office with numbness in the area of the surgery. Because of the use of a long-acting local anesthetic ( marcaine ) the patient may remain “numb” for up to twelve hours– not needing any pain medications.

If someone truly requires a general anesthetic for a very long or difficult surgical problem that cannot be managed in the office, an anesthesiologist will deliver the medications in a hospital setting. Many people remember having their wisdom teeth out under general anesthesia in the hospital. That was very common years ago. In most circumstances, due to safety in the office and technological advancements, hospitalization is not appropriate. It is also extremely costly to go to the hospital for an oral surgical procedure. We are able to provide you with a comfortable and safe experience in our office –and it costs far less!

It is mandatory for Dr. Buche to see a patient on a consultation basis prior to having intravenous sedation. The medical history will be reviewed, medications will be discussed, and the patient will be given information that will make the surgery safe. For instance, the patient may not have solid foods for six ( 6 ) hours prior to the procedure, although clear liquids ( such as apple juice or water ) may be consumed up to two ( 2 ) hours before the surgery. A responsible driver must come with the patient and stay in the office during the procedure and then drive the patient home. Many people have very special medical problems that need to be discussed prior to any intravenous medications being given. Basically, we want you to have all questions answered prior to having intravenous sedation and oral surgery.

There are other things that are very important when it comes to having intravenous sedation. If a person drinks large quantities of alcohol on a daily basis, uses recreational drugs, or even takes certain prescription drugs, tolerance to sedatives may be a factor. Dr. Buche may have to use much higher doses of medications to obtain a normal level of sedation. These are things he really needs to know prior to the surgery for comfort and for overall safety. If the patient has been exposed to recreational drugs for a long time, then there may be risk with intravenous sedation! Anyone who uses recreational drugs must openly talk with Dr. Buche prior to intravenous sedation. It can be a matter of life and death.

Intravenous sedation makes the difference between a comfortable and pleasant experience and one that is less than ideal. Difficult procedures are made much easier for not only the patient, but also for the doctor. You can have confidence in the fact that Dr. Buche is well-trained in the use of intravenous medications and general anesthesia and the management of complications that might arise. He has been delivering safe and effective intravenous anesthesia for many years. Our office has up to date medical monitoring equipment and a well trained staff. If there are any questions regarding anesthetic management in our office, questions are encouraged and welcome!