FAQ

1WHAT IS SEDATION?
During the induction of general anesthesia, five distinct phases of consciousness had been described before loss of consciousness actually takes place. In procedural sedation (PS), we make use of those phases and by careful administration of the drugs we use for PS, we can actually stall the level of consciousness at a point where the patient is awake, well sedated and heart and breathing function unaffected. Various terms for procedural sedation are used, conscious sedation, sedation-analgesia, and MAC, Monitored Anesthesia Care. In principle they all mean the same.
2WHERE MAY SEDATION BE ADMINISTERED?
According the guidelines from all the leading sedation societies in the world, sedation can be administered in a adequately equipped out-of- hospital treatment room, for instance the dental surgery or rooms of a plastic surgeon; or in a hospital theatre or remote location within a hospital, ie endoscopy(gastroscopy/colonoscopy)- or radiology suite. The American Society of Anesthesiologists makes it clear that the care provided and expected of sedation administered in a remote location, have to be equal to the care provided in the in-hospital theatre setting. No less than that.
3HOW WILL MY SEDATION PRACTITIONER KNOW ABOUT MY MEDICAL BACKGROUND?
Prior to your sedation, you will be given a medical questionnaire to complete and sign. Please be as comprehensive as possible and give all the detail requested. No sedation practitioner can be held responsible for any problem you, in your own handwriting and signed by you, did not bring to his/her attention. If you are on a number of medications, please bring all with. It is very important to mention if you suffer from acid reflux (heartburn) and sleep apnoea.
4MAY I CONTINUE TO DRINK HERBAL MEDICATIONS?

Many of the commercially ‘innocent’ herbal drugs have anaesthetic implications and some even affect the clotting of blood.

Two of those drugs need special attention:

  • St JOHNS WORT: this drug has an action similar to an older type of antidepressant and should be stopped at least one week prior to your procedure. This is very important!
  • ARNICA: this drug is a blood thinner and can lead to haemorrhage (bleeding) into the wound and should be stopped one week prior to surgery. Should you have any doubt, please contact your surgeon to refer you to the sedationist.
5WHAT ABOUT MY ROUTINE MEDICATION:

The following are only guidelines, if you take:

  • BLOOD PRESSURE MEDICATION: if your surgery will be performed in the afternoon, take all of your routine medication the morning of surgery. For surgery been scheduled for early morning, consult with your sedation practitioner.
  • ASTHMA MEDICATION: continue with treatment and bring your inhalers with.
  • MEDICATION FOR DIABETES: for surgery scheduled in the afternoon, take your morning medication and have something to eat, all within the fasting guidelines. For surgery early morning, you will be fasting from the previous evening, so DO NOT TAKE YOUR DIABETES MEDICATION OR INJECTION as you will not be allowed to eat prior to surgery
6WILL I BE AWARE OF MY SURROUNDINGS DURING MY SEDATION?
YES. The way your sedation practitioner verifies the level of your sedation, is to either talk to you or to give you a little tap on the shoulder, to which you have to respond appropriately. So you have to be awake enough to respond; if you do not respond, your level of sedation is too deep and the level thereof has to be adjusted. So it is very important for you to be aware of your surroundings.
7HOW WILL SEDATION BE ADMINISTERED?
Sedation can be administered orally, by inhalation, intravenously or a combination of those. The oral way of sedation comprises to be administered a tablet/syrup prior to a procedure. Inhalation sedation is the administration of Nitrous Oxide (laughing gas) for dental treatment. Intravenous sedation is administered intravenously, and unfortunately includes the placement of an intravenous canula (drip).,/div>
8IS LOSS OF MEMORY FOR THE PERIOD OF SEDATION COMMON?
YES. One of the drugs used to reduce the stress levels during sedation is known to cause retrograde amnesia or temporary loss of memory. It is nothing to be concerned about.
9HOW LONG DO I HAVE TO BE NIL-BY-MOUTH (STARVED)?
As one of the complications of sedation is inadvertent loss of consciousness, you have to be prepared as if you will be anesthetised.
  • SOLID FOODS and FLUIDS (all except water and Apple juice): 6 hours
  • WATER and APPLE JUICE: 3 hours
10ARE THERE ANY COMPLICATIONS THAT I SHOULD KNOW OF?
As with all medical and dental treatment, there is always a risk. Risks may be forthcoming from your underlying medical condition/s, body habitus, recreational habits and allergy to some of the medications used. The biggest danger is that of inadvertent loss of consciousness; but sedation practitioners have been trained to manage that. Other problems can be double vision and headache which normally subside after a night’s rest. Post sedation nausea and vomiting occur in less than 1% of patients.
11WHEN MAY I DRIVE MY CAR AGAIN?
It is advised that you do not drive a motorised vehicle, work with power tools or enter into any legal contracts before the next day.
12WHEN WILL I BE DISCHARGED?
Your discharge is according to a discharge scoring system used in all reputable sedation clinics. You will only be discharged in the care of a responsible adult person after contact details have been exchanged and the discharge guidelines been agreed to.
13IS THE BILL FOR MY SEDATION INCLUDED IN THE ACCOUNT FROM THE CLINIC/SURGEON?
NO. All of the sedation practitioners are independent practitioners and you will receive a separate account for the sedation service. Please liaise with the sedation practitioner regarding the detail.
14WHAT HAPPENS IF I AM ALLERGIC TO ANESTHETIC AGENTS
Some people may think that they "are allergic to anaesthetics" because of previous unpleasant experiences such as nausea and vomiting. These are side-effects and not allergies. True allergies include swelling of the mouth, throat or eyes, breathing problems, hives and wheals, and sometimes a drop in blood pressure. It is possible for a patient to show allergic reactions to some drugs, although it seldom happens. If it does happen, it is seldom permanent, because anaesthesiologists are specialists who will notice these reactions immediately and act fast to prevent any permanent damage. Allergy to latex is an increasing phenomenon, but seldom serious.

If you suspect such an allergy you should inform your surgeon and anaesthesiologist in order to avoid rubber products being used. If any allergies occur, you will be tested after the operation so that those products can be avoided in future. You may have to wear a "medic-alert" bracelet. Allergic reactions to one type of anaesthetic does not mean that you will not be able to receive anaesthetics in future.
15WILL I NEED A BLOOD TRANSFUSION?
There are many factors determining the need of a blood transfusion. The most important is the type of operation you will be undergoing and the condition of your own blood prior to the operation. During some procedures the loss of blood is unavoidable, regardless the skills of the surgeon. Most blood transfusions are given directly after or just before an operation. All fluids given in the operating theatre are administered by the anaesthesiologist. Blood is only given when the risk of not giving blood exceeds the risk of giving it. Anaesthesiologists are specialists in the field of making these decisions.
16WHAT ARE THE MOST COMMON SIDE-EFFECTS OF ANAESTHESIA?
  • Sore throat: This is due to the breathing tube in your throat during anaesthesia. At least 95% of all patients have some or other tube in the throat during anaesthesia. This causes friction during breathing, hence the sore throat. Please note - nothing went wrong with the anaesthesia.
  • Pain: This is due to the surgical procedure. Most anaesthesiologists administer pain medication during the procedure. He will also prescribe medication post-operative. Please ask - it is unnecessary to suffer pain.
  • Nausea and vomiting: There are various reasons for this e.g. the type of operation, your pre-operative condition, the use of pain killers as well as the use of anaesthetics. Some anaesthesiologists will administer "anti-nausea" medication during the procedure, but medication will also be prescribed post-operatively.
  • Drowsiness after the procedure: Some patients are very sensitive to anaesthetics. Everybody reacts differently - some people need more than others. Longer procedures also influence the post-operative recovery.
Less serious side-effects may include:
  • Dry mouth or temporary breathing problems.
  • Itchiness, bruising or pain at the spot of injection.
  • Rash due to plasters or medication.
  • Sore neck, sore or dry eyes.
  • Pain in arms or legs due to the positioning during the operation.
  • You may also feel cold and shaky.
  • These side-effects usually do not last long and do not need any treatment
For any questions not included or not discussed, please follow the link on the right hand side of the site to get in touch.