Factors

Minimal Sedation

(No Permit required)

Moderate/Conscious Sedation

(Permit A)

Deep Sedation

(Permit B)

General Anesthesia

(Permit B)

Goal

Decrease anxiety;

facilitate coping skills

Decrease or eliminate anxiety; facilitate coping skills

Eliminate anxiety; coping skills over-ridden

Eliminate cognitive, sensory and skeletal motor activity

Definition

Minimally depressed level of consciousness, produced by a pharmacological method, that retains the patient's ability to independently and continually maintain an airway and respond normally to tactile stimulation and verbal command.  Although cognitive function and coordination may be modestly impaired, ventilatory and cardiovascular functions are unaffected

Pharmacologically induced depressed state of consciousness (altered consciousness, signs of sleep) under which an individual retains the ability to independently and continuously maintain an airway and respond appropriately to light tactile stimulation and oral commands

Pharmacologically induced controlled state of depressed consciousness, accompanied by partial loss of protective reflexes, including inability to respond purposefully to oral commands.  The purposeful response to painful stimulation is maintained

Pharmacologically induced controlled state of unconsciousness accompanied by a partial or complete loss of protective reflexes, including inability to independently maintain an airway and respond purposefully to painful stimulation or oral commands

Personnel

1  (treating dentist)

3  (treating dentist with Permit A; trained person to monitor patient or nurse anesthetist; trained assistant)

OR

3  (treating dentist w/o Permit A/B; physician or dentist with Permit A/B; trained assistant)

3  (treating dentist with Permit B; trained person to monitor patient or nurse anesthetist; trained assistant)

OR

3  (treating dentist w/o Permit B; physician or dentist with Permit B; trained assistant)

3  (treating dentist with Permit B; trained person to monitor patient or nurse anesthetist, trained assistant)

OR

3  (treating dentist w/o Permit B; physician or dentist with Permit B; trained assistant)

Monitoring

Clinical observation and monitoring as appropriate

Preoperative,

intraoperative and pre-discharge monitoring of BP, pulse, respiration and oxygen saturation

Preoperative,

intraoperative, and pre-discharge monitoring of BP, pulse, respiration and oxygen saturation, EKG monitoring.  Defibrillator required

Preoperative,

intraoperative, and pre-discharge monitoring of BP, pulse, respiration and oxygen saturation, EKG monitoring.  Defibrillator required