Analgesia, Anaesthesia, and Sedation

The ability to practise dentistry and provide invasive treatments to pa­tients is based on the ability to make such procedures comfortable and acceptable for patients to tolerate, as well as manage post- operative pain. A good working knowledge of the different treatment modalities available, and analgesic agents that can be prescribed, is key to effective management of patients. This must include the indications and limita­tions of each modality. The pharmacology of most drugs used in modern- day dentistry has changed very little since their introduction, some as far back as 100 years ago. However, it is important to understand the processes regarding their method of action, their effect on the human body, and their indica­tions and contraindications. All of these factors must be considered to maximize the clinical benefit to the patient. Several guidelines regarding the use of conscious sedation in dentistry have recently been introduced, and it is important that those wishing to provide conscious sedation and refer patients appropriately familiarize themselves with these guidelines. Key topics include: ● Principles of analgesia, anaesthesia, and conscious sedation ● Pharmacology and pharmacodynamics of commonly used pharmaco­logical agents ● Indications and contraindications of commonly used pharmacological agents ● Conscious sedation with nitrous oxide ● Conscious sedation with midazolam ● General anaesthesia ● Treatment planning for conscious sedation and general anaesthesia ● Managing complications and adverse reactions