Oral Sedation
Oral Sedation
"Level of sedation is entirely independent of the route of administration. Moderate and deep sedation or general anesthesia may be achieved via any route of administration".
2018 American Society of Anesthesiologist Practice Guidelines for Moderate Procedural Sedation.
Though any level of sedation (including deep general anesthesia) can be achieved with only oral medications. In most instances, oral medication is intended for minimal sedation or used as a premedication in combination with parenteral medications to achieve sedations deeper than minimal sedation.
"The patient should be advised not to drive, make important decisions, or consume alcohol for a period of 24 hours after the appointment." Donaldson M 2007 p. 124
"On the day of the appointment, it would be prudent to administer the medication in the dental office where it is a controlled and monitored environment." Donaldson M 2007 p. 124
Helpful to see patient's baseline before starting medication because some patients will self-medicate increasing their risk for over dosage.
If inadequate sedation, do not give additional oral dose because it takes hours for peak effects so greater risk of over medicating. If need to titrate dose, then give additional medications by parenteral route for quicker, titratable effect but the depth of sedation is now deeper than minimal sedation.
Maximum Recommended Dose
(MRD)
for Minimal Sedation
[Printed in FDA-approved labeling for unmonitored home usage]
Find "MRD"s by Web searching "FDA (medication name) Labeling"
For example
"FDA Triazolam"
FDA Triazolam Label
Peak Plasma Concentration within 2 hours
Mean Plasma half-life 1.5 to 5.5 hours
