WHY IS IV SEDATION RECOMMENDED?
In order to better understand your sedation options and why we recommend intravenous or IV sedation in our office, you first need to understand the following definitions. They include:

• Anxiolysis (light sedation) – This is a drug-induced state during which patients respond normally to verbal command and anxiety is either lessened or eliminated. Although cognitive function and coordination may be impaired, breathing and heart functions are unaffected.
  
  
• Moderate Sedation/Analgesia (conscious sedation) – A drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway, spontaneous breathing is adequate, and heart function is usually maintained.
  
  
• Deep Sedation/Analgesia - A drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully following repeated or painful stimulation. The ability to independently maintain breathing function may be impaired and may require assistance to maintain a patent airway and spontaneous breathing. Heart function is usually maintained.
  
  
• General Anesthesia – Is a drug-induced loss of consciousness during which patients are not arousable, even with painful stimulation. The ability to independently maintain breathing is removed and assistance is required to maintain a patent airway usually through positive pressure ventilation.

Safety is a big reason IV conscious sedation (moderate sedation) is used and highly recommended in our office. As you can see from the above definitions, you are not totally “out” with IV sedation and can maintain your own airway (breathe on your own), but because of the amnestic properties of the drugs you won’t remember much if anything from the procedure and it will seem like you were “out”. With IV access we can easily monitor and adjust your level of sedation to stay in the light to moderate range without getting into deep sedation which is better done in a hospital setting. The IV also provides quick access for emergency drug administration should it become necessary. Your well-being is so important to us that each of the doctors is trained in Advanced Cardiac Life Support (ACLS) procedures to be able to better respond to any emergent situation that may arise.

Another reason we recommend the use of IV sedation for surgical procedures is because it facilitates your comfort throughout, and following the surgical procedure. Knowing that you are completely comfortable allows us as surgeons to do the procedure in a more efficient manner resulting in less trauma to the surgical site, better healing, and less post-operative pain for you.

There are also certain precautions that you the patient will need to follow to make IV sedation more safe and effective. They include such things as not eating or drinking anything 6-8 hours prior to the procedure as well as having an adult escort to drive you to and from the appointment and monitor you for some time afterwards. For a complete list of do’s and don’ts as well as risks and benefits please see the downloadable forms on our website.

WHAT OTHER FORMS OF SEDATION ARE AVAILABLE?
Other forms of sedation utilizing nitrous oxide and oral sedation are also available for use in the office.

• Nitrous Oxide - Nitrous oxide, also called "laughing gas" or "happy gas" is breathed in through your nose and makes you feel like you are floating and tingly. This is completely reversible, and once the gas is turned off, the nitrous will be cleared from your system within 2-5 minutes. You can safely drive yourself home after using nitrous oxide. The nose mask can sometimes be difficult and uncomfortable for claustrophobic individuals and it makes it a little more difficult for the operator to do the necessary procedures.
  
  
• Oral sedation - Oral sedation utilizes a pill such as Halcion or Valium that is taken the night before as well as the hour before the procedure and can cause light to deep sedation depending on multiple factors for each patient. It can help calm and relax you and may even cause you to sleep or be sleepy during the procedure. This drug can be used by itself, or in combination with IV sedation for extremely anxious or nervous patients. The drawback with oral sedation is that you can’t control the level of sedation achieved. As with IV sedation, you will need to have an escort that can drive you to and from the office. You would also need to sign a consent to treatment ahead of time because you are not of a legal state of mind to sign a consent after taking the medicine.