Why conscious sedation?

We are in the midst of a dynamic time for conscious sedation practice which according to all UK sedation guidelines, dentists and doctors are allowed to administer in primary care.

And conscious sedation services will increasingly become even more popular as an alternative to general anaesthesia for various reasons. More research is available that shows that conscious sedation is a safe option for dental procedures in primary care. In studies done by us, patients consistently rate conscious sedation a better option because of the low side-effect profile e.g. nausea and vomiting, cost effectiveness and quick recovery characteristics.

We however need to realize that the concept of conscious sedation outside secondary care presents challenges. Training is necessary, surgeries must meet the requirements of safe practice and we need to follow the guidance from sedation guidelines. We also need to look at patient satisfaction. Do we ask patients whether they are satisfied with every aspect of sedation practice? Another future challenge will be the drugs we use - which ones, how do we administer them, are they safe for use in primary care, and the biggest issue of all, who can administer which drug?

In short, nobody should be involved in providing conscious sedation without training, which must include supervised clinical training in order to optimize patient safety. As the Guidelines by the Academy of Medical Royal Colleges (UK) state clearly, ‘safety will be optimised only if sedation practitioners use defined methods of sedation for which they have received formal training. Relevant qualifications and ongoing training remain the foundation of safe sedation practice’.

As sedation trainers at UCL Eastman, we have responded to the demand for sedation provision and robust training with both our PG Certificate course and CPD activities. We also present an annual Study Club meeting in London where we provide the latest information and guidance on advanced sedation techniques. Our lecturers are recognized internationally as leaders in the field of conscious sedation. We are empowering healthcare professionals, dentists and doctors to become safe sedation providers.

Professor James Roelofse, Former Programme Director, Dental Sedation and Pain Management Certificate