According to the American Society of Anesthesiologists (ASA), surgical procedures in doctors' offices will reach 10 million by 2005, twice the number in 1995. In our office, surgical procedures are provided via local anesthesia or local anesthesia and conscious sedation. Conscious sedation is defined by the American Dental Association as "a minimally depressed level of consciousness that retains the patient's ability to independently and continuously maintain an airway and respond appropriately to physical stimulation or verbal command and that is produced by a pharmacological or non-pharmacological method or a combination thereof." The ADA also states that "patients subjected to parenteral conscious sedation must be suitably evaluated prior to the start of any sedative procedure. In healthy or medically stable individuals (ASA I, II) this may be simply a review of their current medical history and medication use. However, with individuals who may not be medically stable or who have a significant health disability (ASA III, IV) consultation with their primary care physician or consulting medical specialist regarding potential procedure risk or special monitoring requirements may be desirable."
According to the ASA, a pre-sedation assessment includes, but is not limited to:
To administer parenteral (e.g. intravenous) conscious sedation, it is advisable that a periodontist satisfy one of the following ADA criteria:
Also, the following guidelines shall apply to the administration of parenteral conscious sedation in the periodontal office: