Question: Why do I have to be monitored during sedation...my dentist used to give me Valium and never had to monitor before?

Answer: This is very common question especially since monitoring was not alway considered a standard until recently. Most patients that undergo sedation typically are administered multiple medications for not only preparation for the visit but during the visit. A common example is a patient who elects for oral sedation and is prescribed Valium the night before and Triazolam/Vistaril the day of the appointment. In this particular situation, the Valium is used to assist with sleep the night before since most patients have a great deal of anxiety leading up to the appointment. The valium, too, will stay in your body much longer than some of the other medications which can help prolong and strengthen the level of sedation when given with other medications.

The triazolam/hydroxyzine is typically given the day of the apppointment which increases the level of "anxiolysis" or sedaton effects for the patient. While the valium alone does not typically have much effect on the patient in re: vital signs and level of consciousness, additional meds such as triazolam can heighten the sedation to a point where we can see changes in a person's breathing or blood pressure. As the sedation becomes greater the more relaxed a patient can become but also the muscles in the airway and others used for breathing. This is the answer to the original question because sedation can affect the respiratory ability of a patient, it is absolutely imperative that patients are monitored to detect for even the smallest of changes.

By monitoring blood pressure, pulse, oxygen saturation, respirations and sometimes heart rhythms, we can deliver safe levels of sedation to a patient without being as concerned about what may happen in response to the administration of multiple oral medications. Monitoring is an ABSOLUTE must!

Hope this helps!

Dr.G