Intra-venous sedation (IV) aka twilight sedation is a deeper level of anaesthesia achieved by a combination of drugs like propofol, midazolam and fentanyl. It is administered by a venous access made on the forearm. During the procedure, the patient is in a peaceful state of deep slumber, but can be easily aroused if needed. The patient can breath on their own effort and no breathing tubes are necessary. This procedure can be performed in the dental surgery or in a dedicated operating theatre (OT). However, only young and fit patients between the ages of 12-60 are suitable for this procedure.
Propofol has received a lot of bad press recently. All this boils down to the fact that the patients were not closely monitored with equipment during the procedure as well as the drugs were not administered by an anaesthetist. In our clinic, all IV sedation is carried out by an accredited anaesthetist with the Singapore Medical Council. As such, the treatment fees would include the professional fees of both the dentist as well as the anaesthetist. We believe that your safety should not be taken lightly.
Besides anaesthesia, the drug is mildly amnesic, due to midazolam, letting the patient forget about the whole procedure, which is useful for those patients who are fearful of dental procedures and do not want to remember too much about it. Due to this effect, patients are not allowed to go home on their own but with the help of an adult friend. They are also advised to refrain from signing any important documents for the next 24 hours. Patients also loose orientation in time during this process. They may close their eyes and open them again, believing that they only shut them for 5 minutes when in fact, they were asleep for 30 minutes.
As the airway is not secure during IV sedation, procedures that generate too much bleeding or require water irrigation in the mouth are not suitable for this type of anaesthesia.