Under intravenous sedation you will be deeply relaxed, your eyes may be closed, you will respond if we speak to you, and you will usually remember almost nothing afterwards. That is not the same as a general anaesthetic, where you are fully unconscious with your breathing supported. Most people describe sedation as feeling like they were asleep, and for practical purposes that is a fair description.

Will I say something embarrassing?

This is asked far more often than you would think. In practice people are quiet and drowsy, not chatty. Nothing you say under sedation leaves the room.

Continuously: oxygen saturation, end-tidal carbon dioxide, heart rate and rhythm, blood pressure at set intervals, and level of consciousness by direct verbal contact. A trained assistant is dedicated to monitoring throughout and does nothing else.

What are the risks of sedation?

The common ones are nausea, drowsiness for the rest of the day, and bruising at the cannula site. Serious events — a fall in oxygen needing airway support, an allergic reaction, an unexpected cardiovascular event — are uncommon but real, which is why the monitoring, the drugs to reverse sedation, the airway equipment and the training are all in the room before we start, and why we ask about your health so persistently.

Can I have nitrous oxide instead?

Yes, for suitable procedures. Inhalation sedation is lighter, wears off within minutes, and does not require an escort. It suits mild anxiety and shorter procedures, and it is not enough on its own for a difficult impacted lower wisdom tooth in a very anxious patient.

Why do I still need local anaesthetic if I am sedated?

Because sedation does not remove pain. Local anaesthetic does. It is also what keeps you comfortable for the first hours afterwards, which is why we always give it, even under a general anaesthetic.

I have obstructive sleep apnoea.

Tell us, and tell us whether you use CPAP. Sleep apnoea changes how we sedate and sometimes moves a case to a hospital setting. It is one of the most important things you can tell us, and one of the most commonly forgotten.

Anaesthesia

How comfortable you are is a decision, and it is partly yours.

Four options, chosen against the procedure, your health and how you feel about being awake for it. This page explains how the choice is made and what the monitoring actually is.

Permit holderDr. Marcus O. Adeyemi, DDS, MD

FacilityMN Class D office surgical permit (demo placeholder)

TeamACLS and PALS current (demo)

01 · The four options

Local anaesthetic

Awake, numb, and driving yourself home

An injection that removes sensation from the surgical area. You are fully awake and aware, you will feel pressure and movement but not sharpness, and you can eat beforehand and drive afterwards.

Right for most single extractions, most single implants, biopsies and suture removal.

Nitrous oxide

Light inhalation sedation

Nitrous oxide and oxygen through a small nose piece. It takes the edge off, wears off within minutes of stopping, and does not need an escort or fasting.

Right for mild anxiety, shorter procedures, and for people who do not want to be sedated but do not want to be entirely present either.

Intravenous sedation

Deeply relaxed, and unlikely to remember it

Medication through a cannula, titrated to effect while you are continuously monitored. You breathe for yourself and respond to voice, and most people remember very little.

Right for difficult impacted teeth, multiple extractions, longer implant surgery, and for genuine dental anxiety. Requires fasting and an escort.

General anaesthesia

Fully asleep, with breathing supported

Delivered by an anaesthetist in a hospital or licensed surgical facility, with your airway protected and your breathing managed throughout.

Right for orthognathic surgery, major reconstruction, facial trauma, and for patients whose medical history makes office sedation unwise.

02 · ASA classification

How your medical history decides where the surgery happens

The American Society of Anesthesiologists physical status classification is the shorthand every anaesthetist uses. It is not a judgement; it is a description of physiological reserve, and it decides how much of one a procedure will ask for.

ASA physical status and setting
Class	Describes	Typical setting
ASA I	A normally healthy patient	Office sedation entirely appropriate
ASA II	Mild systemic disease — controlled hypertension, well-controlled diabetes, a current smoker, pregnancy	Office sedation appropriate with planning
ASA III	Severe systemic disease that is not incapacitating — poorly controlled diabetes, COPD, morbid obesity, a stent over three months old	Case-by-case. Often better in a hospital setting
ASA IV	Severe systemic disease that is a constant threat to life	Hospital, with anaesthetic colleagues
ASA V	A moribund patient	Not an office population

An emergency modifier "E" is added where the case cannot wait. We record the class in the consultation letter, so the referring practice can see the reasoning as well as the conclusion.

03 · Monitoring

What is watched, and by whom.

Pulse oximetryContinuous oxygen saturation and pulse rate

CapnographyContinuous end-tidal carbon dioxide — the earliest warning of a breathing problem

ECGContinuous rhythm

Blood pressureAt set intervals throughout

Level of consciousnessBy direct verbal contact, continuously

Dedicated assistantOne trained person monitors and does nothing else for the whole case

In the roomReversal agents, oxygen, suction, airway adjuncts, defibrillator, emergency drug kit — checked to a written schedule before every list

A vital signs monitor on an articulated arm beside coiled oxygen tubing in an office surgical suite — Monitoring, office surgical suiteG

Questions

About being sedated.

How to prepare Call (612) 555-0148