Title : ‘I thought I was being knocked out’: An exploration of patients’ understanding of conscious sedation prior to oral surgery treatments
Abstract:
Anxiety is a significant barrier to accessing dental care, particularly for oral surgery treatments. Single drug midazolam sedation is a recognised method to manage patient anxiety. The GDC provides a clear definition for conscious sedation (CS). Valid consent is imperative prior to any intervention, with a patient having sound understanding of the difference between conscious sedation and general anaesthesia.
This prospective survey aims to understand patients’ perception of sedation prior to undergoing oral surgery procedures under CS. Pre-operative questions were asked relating to their understanding of the effects of sedation and their interpretation of the risks, benefits and alternative options.
100 patients were surveyed over a one-month period. Most patients had an appreciation that sedation will have some impact on reducing anxiety (74%), awareness (86%), consciousness (87%) and memory loss (81%). 87% of patients felt adequately prepared for CS. 85% understood the benefits of CS and 72% were aware of risks and alternative options.
Overall, patients attending for treatment in the Oral Surgery Department at King’s College Hospital had a comprehensive understanding of conscious sedation. This suggests that generally, our department is successful in providing sufficient and patient friendly information to prepare patients for IV sedation. This includes verbal instructions supplemented by a written leaflet and an online instructional video that patients watch during the consultation. Current practice in appraising patients for sedation is effective in majority of patients. Focus groups can assist in exploring further the nuances of the interpretation of sedation to further improve the patient experience.
