The intravenous (IV) route of sedation is the subject of Section V. Drugs administered directly into the cardiovascular system produce clinical actions significantly more rapidly than drugs administered via other routes (e.g., oral, intranasal, or intramuscular). Rapid onset of action is both of benefit and of potential danger. It is beneficial because it permits the doctor to effectively titrate the drug to a desired clinical effect; it is potentially dangerous because the actions of intravenously administered drugs develop more rapidly and because their actions are more pronounced than those of drugs administered via other routes with slower onset and less complete absorption. It is therefore of the utmost importance that every person using the IV route of drug administration or contemplating its use receive thorough training in the procedures involved in its safe and effective use.
The chapters that follow provide the basic didactic material for an intensive course in IV moderate sedation. They consist of two parts: The first, a discussion of venipuncture, includes the anatomy for venipuncture, the armamentarium for the continuous IV infusion, and the technique of venous cannulation (venipuncture). The second portion of an IV sedation program is the discussion of drugs and specific techniques of IV sedation, including the clinical pharmacology of intravenously administered drugs, the techniques of administering these agents, and the complications associated with the use of this route of drug administration.
Chapter 29 may prove to be the most important chapter in this section. This chapter is titled Guidelines for Teaching, and it outlines the fundamentals of training required for this very valuable, yet potentially dangerous technique. It is my belief that IV sedation is an important part of the dentist’s armamentarium in the management of pain, fear, and anxiety; however, because of the nature of this technique (e.g., its rapid onset of action, more profound eff/>