Risks of sedating infants
Ideally, a conscious sedation drug technique should have a margin of safety wide enough to make loss of consciousness unlikely.These are specialist sedation techniques and they risk causing unintended deep sedation or anaesthesia.
In dentistry in the UK, conscious sedation techniques are of two types: basic and advanced (formerly known as standard and alternative).It is important therefore to always be prepared for deep sedation.Sedation should only be undertaken where there are the facilities, equipment, and personnel to prevent or manage deep sedation.Advanced techniques have a reduced margin of safety and should only be used by a specialist team.Many children undergoing minor procedures need effective sedation, or anaesthesia, because they are frightened, in pain, ill, or have behavioural problems.Likewise, anxious patients are probably unsuitable unless they are motivated.
There are risk factors that may influence the choice of technique and the consenting process.
When a child will not cooperate, it is tempting to increase the dose.
In most techniques, for an individual child, it is not possible to be certain what dose or doses can cause deep sedation.
It is similar to ‘moderate’ sedation except that the patient always remains responsive to the spoken word; this definition is used most commonly in dentistry.
There is a difference between ‘conscious’ and ‘moderate’ sedation, but the terms are close enough to make it reasonable to consider them to be equivalent in this article.
In addition to understanding the current medical and surgical problems, the sedationist should assess the child's growth, previous sedation or anaesthesia, and the drug history.