What is drug-induced sleep, how and where is sedation used?

Doctors call medicated sleep sedation. This condition is caused by the use of sedatives and even narcotic drugs.

The presence of innovative technologies in anesthesia allows you to choose an individual approach for each case. When a patient undergoes a painful surgical procedure, he will fall into a sound sleep without feeling pain. When you plan to work on a tooth, just take a nap. Modern drugs are many times more powerful than morphine, so the dose of medication can be used minimally.

Innovative drugs do not provoke complications, are eliminated from tissues almost instantly, and do not depress breathing. Having woken up, the patient can go home independently within half an hour.

Basic moments

Since the key goal of the procedure is pain relief, most patients have a question about how anesthesia differs from drug sleep. The latter has become an excellent alternative to traditional pain relief, since the person remains conscious and has all the usual reflexes.

When studying how a person feels during medicated sleep, keep in mind that the administered drug:

• calms;
• relaxes;
• provides an analgesic effect.

To place a person under sedation, they are given a prescribed drug. This type of anesthesia is recommended:

• persons with a low pain threshold;
• children;
• patients with mental disorders.

The calculation of the quantity and administration of components is carried out by an anesthesiologist. Later, the doctor ensures that the patient comes out of the sedative state. In some cases, local anesthesia is prescribed in parallel with sedation. Experts note the following advantages of the method:

• minimum doses of medications;
• lack of addiction;
• breathing is not suppressed during the process of falling into sleep;
• reflexes are preserved;
• quick exit from sleep.

Side effects are very rare.

Indications

Indications for the procedure of artificial coma may include manipulations that require complete absence of movement.

Sedation is used for the following groups of people:

• people who have a low pain threshold, which can interfere with both the doctor and the patient;
• patients with any mental or physical disabilities that do not allow them to correctly follow the doctor’s commands;
• people with increased anxiety about their health;
• children. Eliminate the possibility of the child receiving stress or psychological trauma during complex diagnostic or therapeutic procedures. The child does not clearly understand the motives of the doctor’s actions and cannot interact correctly with the doctor.

Sedation depth

The duration of drug-induced sleep and its depth depend on the specific situation and the amount of drug administered:

1. The minimum level requires the ability to communicate with others. For example, the patient may be conscious and talking to the physician. In this case, there is a slight lack of coordination of movements, a slight change in intellectual abilities.
2. Moderate (average) level - the sleeper is receptive to words and tactile actions.
3. Deep level - the patient is completely deprived of contact with the outside world. It will require quite unpleasant stimulation to awaken him. In some cases, breathing difficulties may arise, but even in such a situation, the activity of the cardiovascular system remains stable.

Due to this variety of effects, the procedure can be used in various situations, including for the treatment of children. Medicinal sleep after surgery allows you to restore strength and relieve stress after the intervention.

Preparation for the procedure

Another undeniable advantage of medicated sleep in dentistry is the absence of serious and complex preparation. First of all, the patient must undergo a consultation with an anesthesiologist, then, in exceptional cases, undergo a series of tests and undergo some examinations to assess his state of health and exclude contraindications.

Recommended, but not mandatory for all studies include:

1. General clinical blood test.
2. Biochemical blood parameters (the renal complex is of utmost importance, in particular the level of creatinine).
3. Coagulogram (test to identify blood clotting problems).
4. Test to detect HIV infection.
5. Tests to detect viral hepatitis B and C.
6. Wasserman reaction (test for syphilitic infection).
7. Electrocardiogram (assessment of the cardiovascular system).

Important! This list of tests is standard for many therapeutic and surgical procedures, and therefore is not considered specific preparation specifically for your medicinal sleep. Based on the initial consultation and examination results, the doctor, together with the anesthesiologist, decides on the type of anesthesia.

No special preparation is required for medicated sleep. You should avoid eating 4-5 hours before going to the dentist, and if possible, limit your drinking. It is not recommended to drink caffeine-containing drinks, including strong tea, the day before treatment. You should avoid alcohol and highly carbonated drinks. As for specific medications that the patient constantly takes, the issue should be discussed in advance with the anesthesiologist. This is especially true for heart medications and psychotropic drugs.

Important! Our clinic has been practicing the Anti-AIDS-Antihepatitis sterilization program for infection control for many years, so tests for RW, HIV, and hepatitis are not mandatory for our patients. We have our own sterilization station and disposable kits. When implementing the requirements of this technology, the clinic works with all patients at the highest level of security, as if everyone has an infection, and does not require blood tests.

Popular drugs

For drug-induced sleep treatment to be successful, the selected drugs must meet a number of characteristics:

• minimal likelihood of side effects;
• absence of prolonged depression of consciousness - after administration of the drug, the patient’s consciousness should quickly recover;
• fast action - medications should stop their effects after 5 minutes, maximum 10 minutes.

Midazolam is used when it is necessary to put the patient into light sleep. Moderate sedation is caused by the drug Propofol. An additional element that provides calm and complete relaxation is nitrous oxide, supplied to the visitor through a breathing mask.

In some situations, doctors use barbiturates. However, such drugs are considered not the best solution. When exposed, they have a negative effect on the heart; constant monitoring of the smooth functioning of the circulatory system is required. However, such drugs are used less and less.

Reanimation

Doctors recommend medicinal sleep, also known as narcotic sleep, in intensive care when the patient has suffered a serious head injury or other serious injuries. The peculiarity of the condition is that its duration is calculated not in minutes, but in days.

The main advantage of this solution is the ability to give the brain a rest and reduce intracranial pressure at high levels. During the period of sedation, doctors will have plenty of time to prepare the optimal tactics for treatment.

Often, medicinal sleep is resorted to in situations where the patient is in distress, and specialists cannot decide on the choice of treatment. Along with the use of any type of anesthesia, prolonged use of medicated sleep can lead to disturbances in the nervous system of the sleeper.

Birth of a child

Medication-induced sleep during childbirth is prescribed only if the woman in labor so desires. To make a positive decision, an obstetrician's opinion will be required. The doctor carries out a general analysis of the situation and the condition of the expectant mother.

Sedation is recommended only for long-term labor. The measure is considered necessary in the presence of severe pain that deprives a woman of strength and impairs consciousness. Exhausting painful contractions do not contribute to the positive course of labor. In addition, in such a situation, the baby may also suffer.

During a light sleep, the expectant mother will easily regain her strength. The medications used have mild anesthetic properties. Painful sensations will not disappear completely, they will be muffled a little, and contractions will occur with the same frequency.

During childbirth, sedation is carried out in several stages:

1. The first stage involves the use of relaxing, pain-reducing compounds. A negative point is the possibility of the drug penetrating the placenta. As a result, the newborn baby may also fall asleep.
2. The second stage is the use of sedation drugs. They have minimal toxicity, are safe, and cannot cause breathing problems in a child.

Most mothers who have been prescribed sedation note an improvement in the labor process.

Levels of medicated sleep

The level of sedation is adjusted by the anesthesiologist with the dose depending on the goals and individual characteristics.

At the easiest level, communication with the patient is possible. He is conscious, reacts to the words and actions of others, but at the same time, physical sensations and intellectual activity are dulled.

At a deeper level, the subject is dozing, but can also respond to speech and actions.

A deep level of sedation is similar to anesthesia and involves complete immersion of the subject in sleep.

There is no reaction to any stimulation, awakening requires effort, breathing and consciousness may be impaired.

Dentistry

Dental treatment is an area in which the euthanasia procedure has received maximum demand. Compared to general anesthesia, which is used in the process of all kinds of manipulations, drug-induced sleep in dentistry provides more benefits and guarantees greater safety.

Sedation is recommended for patients with allergies to local anesthesia when complex, painful procedures are required.

Even considering the fact that innovative technologies are used in dentistry, most visitors are still afraid to sit in the dentist’s chair. Using light sleep, it will be easier to perform all the required manipulations in the patient’s mouth without fear of sudden movements.

All kinds of psychological disorders also become an insurmountable obstacle to the work of a dentist. By putting the patient to sleep, the specialist is able to perform high-quality treatment of all teeth in one visit.

Medication-assisted sleep for children is no less in demand in dentistry. It is recommended for very young children who find it difficult to explain how to behave correctly, as well as for those who are terrified of doctors and their instruments.

Features of medicinal sleep in modern dentistry

First of all, it should be noted that drug-induced sleep in dentistry is not synonymous with standard general anesthesia. Therefore, patients can immediately put aside panicky thoughts about a long recovery from unconsciousness and forget about various side effects.

Important! Anesthesia, sedation and drug-induced sleep are three different states created by different drugs for different treatment procedures.

Sedation or drug-induced sleep in dentistry is a specific method of anesthesia that involves immersing the patient in a state of superficial sleep. The person does not switch off completely, but only relaxes, calms down and stops panicking. Medicines for introducing the patient into such a state are supplied by inhalation. Medicinal sleep is not a replacement for standard anesthesia, but only its addition. This condition does not imply the loss of pain sensitivity, and therefore the introduction of standard painkillers is mandatory.

Benefits of medicated sleep:

• short period of action, instant recovery from sleep;
• absence of discomfort and pain during the treatment process;
• complete calm and relaxation (the patient does not pay attention to the doctor’s manipulations or the noise of dental equipment);
• maintaining the ability to respond and interact with the doctor;
• quick entry and easy exit from the half-asleep state without any adverse consequences;
• absence of unpleasant memories about the treatment process;
• gradual acquisition of the skill “not to be afraid”;
• the possibility of carrying out extensive treatment of the dentofacial apparatus (in a couple of hours of medicated sleep, the dentist manages to do the work in 3-4 standard visits);
• the selection of drugs and dosage is carried out on an individual basis, which allows for a minimal reduction in the drug load on the patient’s body.

Important! To carry out medicated sleep, only completely safe and non-narcotic drugs are used that do not cause addiction and complex “after” conditions.

The doctor always has the opportunity to quickly wake up the patient and take an x-ray or, for example, let the patient go to the toilet. A qualified anesthesiologist carefully monitors the condition of the human body during treatment using modern equipment. There is no risk, especially since medicated sleep is used even in young children.

Patients return home immediately after treatment; there is no need to stay in the clinic. It is only temporarily prohibited to drive vehicles or any dangerous devices, since at first the reaction speed will be slightly reduced. Usually, we ask you to stay at the clinic for 20-30 minutes for tea, then you can get behind the wheel.

Are there possible negative consequences?

Looking through information about new methods of work by doctors, a legitimate question arises whether drug-induced sleep is dangerous. When answering this, it is worth considering that taking any medications can cause individual intolerance to elements or the drug as a whole. The sedation procedure itself is rarely accompanied by side effects. Among them are:

• dizziness;
• vomit;
• feeling of nausea.

In the presence of chronic diseases, such a procedure is not prescribed.

Most doctors agree that in the process of preparing for medicated sleep, the patient must undergo a cardiogram, fluorography, and provide the results of a general blood test. This makes it possible to eliminate risks and provide a firm guarantee that during the sedation process the patient will not have any difficulties with the respiratory system or heart function.

To eliminate the harm of medicated sleep, the doctor must know:

• whether the patient takes any medications on an ongoing basis;
• whether the woman has an expected or existing pregnancy;
• Do you have any allergies?

When the procedure proceeds normally, after sedation the patient quickly and easily comes to his senses.

Advantages and disadvantages

Advantages:

• mild effect on the nervous system;
• stress prevention;
• operative rehabilitation;
• no addiction to sedatives
• low likelihood of side effects;
• indicated for blood pressure disorders.

Flaws:

• medicated sleep has contraindications: chronic diseases, allergies to medications, epilepsy, the presence of acute infectious diseases, alcohol, drug use;
• Long-term use may lead to disorders in the nervous system.

The use of various medications can be accompanied by unpleasant consequences.

Coma is rarely accompanied by side effects, but some patients may experience dizziness, nausea, vomiting within 40 minutes after waking up, and weakness, drowsiness, poor coordination, and low blood pressure during the day.

These symptoms will soon subside. Sometimes there is an allergy to certain substances or individual intolerance.

With the correct selection of the drug and dosage, the risks of negative effects are practically eliminated, and resuscitation promises to be quick and painless.

Effect on memory, health

Previously, there was an opinion that drug-induced sleep could affect the patient’s overall health, worsening it, and would also negatively affect memory. However, modern anesthetics do not have such unpleasant effects. They are not able to influence the intellect of the sleeper or dull his memory.

Within forty minutes after receiving the drug, the patient feels:

• drowsiness;
• slowness of reaction;
• coordination problems;
• temporary dulling of attention.

All of the above consequences are reversible, reactions are restored after the drug is removed without additional effort on the part of the doctor or patient.

When planning sedation, a person must understand that in the first hours after waking up he will have to give up:

• complex activities that involve mental stress - the work may not bear the expected fruits;
• control of any transport.

Certain anesthetics can induce hallucinations and unusual dreams. However, the use of such drugs is becoming less common.

The risk of not waking up

You should never worry about falling asleep and not coming out of the state of sedation. A negative attitude is not needed in any business, especially during medical procedures.

When planning medicated sleep, keep in mind that risks are always present. The more complex the procedure, the higher their likelihood. You can minimize the risks by choosing a good clinic where the drugs will be prescribed and the doses will be calculated by an experienced anesthesiologist.

Today, drug-induced sleep has become a safe, clearly controlled procedure that is much easier to tolerate by the patient than general anesthesia. The medical staff is well trained and aware of all the unexpected things that can happen during a narcotic sleep session.