[Maggok Sleep Dental Clinic] Is Sedation Safe for Patients with High Blood Pressure or Diabetes? (Differences from General Anesthesia)

Hello.

This is Magok Sleep Dental Clinic.

The biggest reason people hesitate to get dental treatment is their fear of pain.

In particular, people with chronic conditions such as high blood pressure or diabetes often worry,

"Is it okay to receive anesthesia with my current condition?"

and end up missing the right time for treatment.

In today’s post, we have organized the information patients often ask about based on medical evidence.

If you are busy, you may use the table of contents below to check the information you need first.

[Today’s Preview]

1. How is sedation different from general anesthesia?

2. Can patients with high blood pressure/diabetes receive sedation treatment?

3. The 4-step system for safety

4. Top 4 frequently asked questions (recovery, fasting, driving, etc.)

5. Is sedation the same as general anesthesia?

Many people confuse the two,

but the exact medical term for sedation performed in oral healthcare settings is

"conscious sedation."

This is clearly different from the general anesthesia used at university hospitals.

• General anesthesia

A state in which consciousness is completely lost,

spontaneous breathing is impossible,

and the patient must rely on a ventilator.

• Conscious sedation

A light state of sedation in which the patient is induced into a drowsy, half-asleep state

while maintaining spontaneous breathing,

and can still respond to verbal instructions from the medical staff.

At Magok Dental Clinic,

we explain it as being similar to

"a state like taking a pleasant nap, blinking off under warm sunlight."

Pain and fear are blocked,

but because you can breathe and move on your own,

the physical burden is lower.

2. Can patients with high blood pressure or diabetes receive it?

To give you the conclusion first,

patients with chronic conditions that are controlled with medication can receive conscious sedation safely under careful monitoring.

In fact, for patients with severe dental anxiety and high blood pressure,

when receiving treatment while fully awake,

there is a risk of "Dental Shock," where blood pressure rises sharply due to excessive tension and stress.

In such cases, performing conscious sedation can be more advantageous because it induces psychological and physical relaxation,

allowing the procedure to proceed while keeping blood pressure at a stable level.

At Magok Sleep Dental Clinic,

for safety, we believe it is best to perform the following pre-assessments first.

1. Check current medications

Whether the patient is taking antithrombotic drugs such as aspirin or warfarin, and establish a plan for diabetes medication adjustment

2. Check condition on the day of treatment

Precisely measure blood pressure and blood glucose when the patient visits on the day of the procedure

3. Evaluate the airway and breathing

Assess the ability to maintain breathing by checking factors such as obesity and jaw structure

3. The 4-step system for safety

For safe treatment,

a systematic protocol is essential.

At Magok Sleep Dental Clinic,

we believe the following system is necessary,

with safety as the top priority.

Step 1.

Real-time monitoring

Monitoring should be done with specialized equipment that tracks pulse, blood pressure, oxygen saturation (SpO2), and electrocardiogram in real time.

Step 2.

Establish IV access and administer medication

A sedative with proven safety, such as Remimazolam,

is administered in a measured dose according to the patient’s body weight,

and using a device called an infusion pump,

the medication is continuously infused at a constant rate to help ensure safe anesthesia.

Step 3.

Induce a drowsy state and perform local anesthesia

Once it is confirmed that the patient has reached a comfortable drowsy state,

local anesthesia is administered in the mouth to block pain.

Step 4. Safety measures

In preparation for any emergency situation or the need for rapid recovery,

all staff must complete CPR training, and

a reversal agent (flumazenil) that can immediately neutralize the effect of the medication and awaken the patient must be available.

4. Top 4 frequently asked questions

• recovery, fasting, driving, etc.

We have organized the questions most often asked about conscious sedation

in a Q&A format.

Q1. Can I wake up during sedation treatment?

A. Yes, you can.

Conscious sedation is not deep sleep,

but a drowsy state, so the medical staff

may be able to wake you briefly if they speak to you or if there is a loud noise.

However, thanks to "anterograde amnesia" (the memory-loss effect),

after the procedure is over,

you will hardly remember the pain or unpleasant sounds from the treatment,

and you may feel like, "I just slept for a moment and then it was over."

Q2. Should patients with diabetes

take their medication on the day of surgery?

A. Caution is needed.

For sedation treatment,

you must fast (including water for 6 to 8 hours),

and if you take diabetes medication without eating,

there is a risk of hypoglycemic shock.

Therefore, diabetes medication should be stopped on the morning of surgery,

or adjusted after consulting the doctor in charge of the condition.

(By contrast, blood pressure medication is generally taken as usual with a small amount of water,

but it should be adjusted after consulting the doctor in charge of the condition.)

Q3. Is it the same as sleep endoscopy?

A. The principle of using medication to induce sleep is similar, but the setting is different.

Endoscopy is sedation for examination,

※ Source - Airway Management during Sedation - Department of Dental Anesthesiology and Pain Medicine, Pusan National University School of Dentistry

while conscious sedation requires the mouth to remain open during the procedure,

and care must be taken to prevent water from entering the airway, so airway protection (maintaining breathing) is important.

Therefore, at Magok Sleep Dental Clinic,

we explain that it is best to proceed in a place with a system that can professionally monitor breathing

and with experienced medical staff.

Q4. How long is the recovery time?

Can I drive right away?

A. Although it varies by individual,

most patients can go home after resting in the recovery room for about 30 minutes to 1 hour after the procedure.

However, even if you look fine on the outside,

residual drug effects may remain in the body,

which can blur judgment.

Therefore, self-driving on the day of treatment is absolutely prohibited,

and you must use public transportation.

Today we looked at whether sedation is safe for patients with high blood pressure or diabetes

(and the differences from general anesthesia).

Fear of treatment is not caused by being weak-willed.

It is a natural defense mechanism of the body,

and it can be sufficiently managed with the help of medicine.

Even if you have a chronic condition,

or even if you have severe dental phobia,

don’t give up,

and we recommend receiving treatment comfortably through safe conscious sedation.

This has been Won Yoo-jin, director of Magok Sleep Dental Clinic.

Thank you for reading this long post.