Drugs Suitable for Moderate Periodontal Sedation

Abstract

The safety and efficacy of moderate sedation depend upon the administration of drugs that have a low potential to progress to the level of deep sedation or general anesthesia. Drugs described in this chapter have a wide enough therapeutic index to be useful for moderate sedation. Opioids raise the pain threshold, modulate stress, and act to potentiate the effects of other agents. Benzodiazepines provide anxiolysis, sedation, and amnesia. They provide the backbone for the moderate sedation technique. Alpha-2 agonists such as dexmedetomidine also produce sedation, elevate the pain threshold, and attenuate cardiovascular stress. The key to drug administration is not fixed dosing, but rather slow titration to a defined clinical endpoint. In this way patient comfort is achieved, consciousness is maintained, and treatment conditions are optimized.

Among the remedies which it has pleased Almighty God to give to man to relieve his sufferings, none is so universal and so efficacious as opium.

—Sydenham, 1680