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What is the correct dose when receiving sedation?

I hope you can give me some advice and your opinion?
I have been struggling with dental phobia – but I had to go to the dentist 3 weeks ago due to a root infection with facial swelling. I agreed to undergo the extraction under IV sedation which was done last Friday.
I don’t feel it went well!
I don’t believe I was sedated – he seemed to struggle to get the drug in. He asked me if I had trouble giving blood as he couldn’t find a vein – (I have had a vein go into spasm before when I gave blood) It felt like it took him around 5 minutes to do the IV injection and afterwards I noticed I had two puncture holes on my arm. I was fully aware throughout the whole procedure – I can describe everything that happened including the sensation of my gum being cut either side of the tooth – the sensation of my tooth cracking! The nurse checking my BP!
When I left the dentist I only felt slightly dizzy.
Could it be that I am not affected by the drug or I believe I only had a small dose, nowhere near enough to sedate me.
Previously he has done a local anaesthetic that has made my throat numb and my mouth was unaffected – this has happened twice although I don’t feel like he believes me. I am reluctant to ask him about the IV Sedation as I don’t feel he will be honest with me but it will affect how I have any future work done.
I know it has worked for others from speaking to some of my colleagues!

Hello ,
Im sorry your experience was not as good as you hoped .
the two puncture marks may have been due to the difficulty getting IV Access .
If the drug was just a single one called midazolam , then it has to be given slowly and matched to how the patient is responding .
There are some patients who are not sedated deeply enough with Midazolam only , or to get deep enough sedation would need a dangerous dose of the drug .
Every person responds differently to sedative drugs , some being sedated with a very small dose , others as with yourself finding you still are too aware for your comfort .
Dont be afaid of describing your experience because as you rightly say your future treatment choices may be affected by this , every dentist who gives sedation comes across this occasionally ..
I have a very experienced dental anaesthetist for my patients , who gives a cocktail of two or three drugs Almost all people remember nothing about the procedure , even though still safely consciously sedated .
However I have had the occasional person who even at that level has not been comfortable , and Ive referred to hospital for a full general anaesthetic . .

Answer provided by: Dr Jennifer Pinder Retired
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