Instructions Before Sedation

Instructions Before Sedation

Eating and drinking instructions- one of the most important safety parameters for anesthesia provision is following appropriate guidelines for eating and drinking. Failure to properly follow these guidelines can result in a catastrophe for the patient during anesthesia. The challenge with restricting eating and drinking is the time of the procedure. Everyone wants the early morning case as it is typically the most convenient for the patient and easiest to restrict food and fluids. Obviously, it is impossible to only see patients first thing in the morning so it becomes necessary to schedule patients at different times during the day. With the revision of guidelines for eating and drinking, this really does not become such a problem as it has in the past. If the patient has a feeding tube, it will be important to discuss with our office appropriate guidelines with respect to administering anything to the patient before the appointment.

The current guidelines recommend the following:

  1. Eating- no solid food, semi-solid food or any type of dairy product should not be consumed less than six (6) hours prior to an appointment
  2. Drinking- clear liquids (water, juice, Pedialyte, Gatorade, soda) can be consumed up to two (2) hours prior to the appointment
  3. Examples-
    1. If you have an appointment at 11:00 AM- food would have to be consumed before 5:00 AM and fluids could continue until 9:00 AM. Now, it may be impractical to eat before 5:00 AM, but it would be fine to drink as much clear liquids up to 9:00 AM
    2. If you have an appointment at 2:00 PM- food would have to be consumed before 8:00 AM and clear fluids could continue until Noon. So, it would be fine to have breakfast before 8:00 AM and drink clear liquids until Noon.

Dressing for the Appointment

The best clothing to wear is pajamas! You are encouraged to wear loose, comfortable clothing. With colder weather, layering is the best. The provision of anesthesia requires access of your arms and legs for monitors and the administration of medications. Wearing tight clothes, belts or other clothing extra (leggings/thermals under pants, extra shirts, and tight long sleeve shirts) make it more difficult to care for the patient. Accidents happen. For this reason, we do recommend that the patient bring an extra set of undergarments and clothes just in case!

Medications

Unless specifically advised, it is recommended to take all medications as prescribed. If medication is required before an appointment, it is recommended to take the pill/tablet with a very small amount of water. If medication must be taken with food, it is recommended to take the pill/tablet with a very small amount of applesauce. It is not typically necessary to stop taking any medications before an anesthesia procedure. It is important to make sure to report all medications that you take including medication prescribed by a doctor or that you purchased on your own from the drug store. It is also recommended to make sure you ask about your medications if you are in any way unsure of what to do.

Sickness

It is very important to ensure optimal health for an upcoming dental appointment when sedation will be administered. The most important issue to address is communication. If a procedure is scheduled and the patient is sick or ill prior to the date of the appointment, it is recommended to contact our office to discuss the situation and determine the best course of action. Sickness alone is not necessarily a reason to cancel an appointment. Depending on what symptoms the patient has will determine whether the procedure should be rescheduled or not. The following are general guidelines to follow;
  1. Elevated temperature is not a reason to cancel an appointment. The best recommendation is to use a thermometer to accurately obtain the patient’s temperature. If the temperature is significantly elevated, then the procedure should be rescheduled.
  2. This is one of the more challenging areas to assess and evaluate. If a patient is congested, the condition needs to be examined. The color and thickness of the discharge will help determine how ill the patient is currently and what to discuss with our office.
    1. Examples-
      1. Clear, ‘runny’ discharge
      2. Yellow, thick discharge
      3. Green, very thick discharge
  3. Coughing. The important issue with coughing is whether the cough is productive or not. A dry cough though possibly uncomfortable may not be as significant as a cough where the patient is able to produce discharge. Though not necessarily a reason to reschedule an appointment, a productive cough should be evaluated and assessed similar to congestion.

Escort

No patient who receives sedation can operate a vehicle following discharge from the dental office! Additionally, patients will require at least one adult to provide observation and supervision for a period of three to four hours after leaving the dental office. Sometimes it can take longer for a patient to fully recover and it is advised to make arrangements to stay as long as necessary with the patient. The main concern is balance and coordination. If a patient attempts to move on their own without assistance, they could suffer an injury. It is our best recommendation for any patient to have a responsible adult stay with them until they are fully recovered.

  1. The medications administered for the procedure affect memory and this effect lasts after the procedure is completed. It is important to have someone with the patient to ensure that the patient doesn’t do something and then forget about it with the possibility of a resultant accident. For example, the patient lights the stovetop to cook something and then forgets about it and a fire result. It is also advised not to make any type of important decisions or buy something due to the potential of not remembering what was done by the patient.
  2. Adult Patients with Special Needs. Depending on size of the patient or their ability to ambulate, it may be required to have more than one adult available to assist with the safe and appropriate transfer of the patient to the vehicle at the completion of the procedure. It is also recommended to consider using a wheelchair (its available at our office) to the appointment to facilitate transfer.

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