What are the indications and contraindications to IV sedation?
Referenced from Practice Guidelines for Intravenous Conscious Sedation in Dentistry (Second Edition, 2017), Developed By The Japanese Dental Society of Anesthesiology for Dentists Practicing Sedation in Japan
Indications include the following:
- Dental phobia
- Patients undergoing invasive treatment
- Gag reflex, hyperventilation syndrome, and panic disorder likely to develop from dental treatment
- Strong vomiting reflex, vasovagal reflex
- Patients who require stabilization of intraoperative circulatory dynamics (patients with hypertension, heart disease, etc)
- Patients with cerebral palsy who have severe athetosis or spasticity
- Patients with Parkinson’s disease who have severe tremor
The purpose of intravenous sedation is to relieve stress. In the case of patients with cerebral palsy, muscle tension and involuntary movements are frequently worsened by stress and can be relieved by intravenous sedation. In patients with Parkinson’s disease, tremor at rest can be reduced by intravenous sedation.
Contraindications include the following:
- Patients in early stages of pregnancy
- Patients who have an allergy to the sedative
- Patients who are using a contraindicated drug as listed below
- Patients with myasthenia gravis (diazepam, flunitrazepam)
- Patients who are using a protease inhibitor (eg, ritonavir) for treatment of HIV (diazepam)
- Patients with acute angle-closure glaucoma (diazepam, flunitrazepam)
Dental Surgery and Sedation 