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Sedation in the Dental Office: An Overview

Course Number: 464

Sedation Continuum

Just as the history of sedation is a continuum of events and discoveries, it is important to understand that sedation itself is a continuum. The boundaries between the different levels of sedation may not always be evident to the untrained or inexperienced and progression from one level to a higher level may quickly occur as patients do not always respond predictably to any particular sedative agent, i.e., they may respond idiosyncratically. Table 1 summarizes the different levels of sedation continuum and their characteristics.

Table 1. The Sedation Continuum.

LevelResponsivenessAirwaysVentilationCardiovascular
MinimalNormalNot affectedNot affectedNo change
ModeratePurposeful responseOpenAdequateMaintained
DeepRepeated painful stimulusMay need assistanceVentilation may be impairedUsually maintained
GeneralNo response/not easily arousedOften needs assistanceImpaired/needs supportMay be impaired