Medical Emergency in the Dental Surgery 2026 -Part 4 – Sedation update and Ozempic
Sedation
A cocktail of certain medications is delivered by the anesthetist into a vein, usually near the wrist. The doctor monitors the patient and, with the aid of a pulsimeter, their pulse. The majority of patients have complete amnesia of the procedure, but in a certain number have minor awareness. This procedure is also called conscious sedation, as the patient is able to breathe on their own.
The anesthetist will do a medical assessment to see if you are a suitable for sedation.
The Anesthetist when giving sedation insists on clear patient protective glasses instead of tinted glasses. He needs to see if the eyes have dilated and the colour of the skin of the face.
You need to fast nil solids & nil clear fluids before the surgery but the doctor will advise the how long before the procedure.
There must be an adult carer to drive you home because you will:
- NOT be able to drive a motor vehicle after the procedure for that day.
- Need assistance with walking for a minimum of 2 hours post procedure.
There is an additional charge for sedation depending on the length of time of the procedure. There will be a claim from Medicare.
The item number for the health fund follow
942 – Sedation – intravenous – per 30 minutes
Sedative drugs are administered intravenously usually in increments while dental procedures are carried out. They are a cocktail of medications that are usually used, provide amnesia and relaxation during the procedure BUT the patient remains conscious and can breathe on their own. The patient must be constantly monitored. The people administering the sedatives are usually medical anesthetists or specially trained and certified dentists.
949 – Treatment under general anaesthesia/sedation
An additional item used to describe the treatment of a patient under general anesthesia/sedation administered by another registered practitioner. The treatment itself should be itemized separately. This item takes into account set up and recovery time, as well as the dental treatment must take into account the sedative state of the patient
928 – Intravenous cannulation and establishment of infusion
This involves a venipuncture, insertion of a cannula within the vein and achieving infusion. This is often used for sedation.
Oximeter or Pulsimeter
The oximeter is a portable non-invasive, spot check of oxygen saturation of arterial haemoglobin and pulse rate of an adult and paediatric patients at home and in hospital.
A healthy patient: Pulse rate should sit between 60-100 per minute for an adult, and a child between (9-15 years) should be 80-100 per min.
A healthy patient: SpO2 (oxygen saturation) for an adult, and a child from (9-15years), should be also 95%-98%.
However, pulse rate adult and child (9-15 years) of above 100 per minute or below 50 per minute, and SpO2 (oxygen saturation) for an adult, and a child from (9-15years) below 95%, and in adults of below 88% (COPD) chronic obstructive pulmonary disease.
These readings indicate a person going into shock. So, if for some reason you notice that a person does not seem right or their showing signs of poor perfusion (example) they appear to be confused or aggressive look pale or cold and sweaty it’s important that you reassure the patient and deal with the situation at hand in a calm and collected manner.
Important aspects of Sedation – Ozempic
Ozempic injection used for weight loss, causes slow motility of the muscle of the muscle of the gastro-intestinal system, increasing the risk of pulmonary aspiration.
Ozempic (semaglutide) and similar GLP-1 receptor agonists (such as Wegovy) work by mimicking a hormone that slows gastric emptying—the speed at which food leaves the stomach—which increases satiety and aids in weight loss. This mechanism of action can lead to a state where food remains in the stomach for longer periods, which has been associated with an increased risk of pulmonary aspiration during procedures requiring anesthesia or deep sedation.
Key Concerns Regarding Ozempic and Aspiration Risk:
- Mechanism: The drug slows motility of the smooth muscle in the stomach, which can cause a “full stomach” (retained food) even after a patient has complied with standard pre-procedure fasting guidelines.
- Aspiration Risk: Pulmonary aspiration occurs when stomach contents are regurgitated and inhaled into the lungs while airway reflexes are relaxed under sedation, posing a life-threatening, albeit rare, risk.
- Case Studies: Reports have emerged, including cases at major hospitals, of patients experiencing regurgitation of food during endoscopy or surgeries while taking GLP-1 agonist medications.
- Recommendation: The American Society of Anesthesiologists (ASA) and other health authorities advise that patients should discuss their use of these medications with their doctor and may need to hold the medication for a week or more prior to elective procedures.
- Symptoms: This effect can lead to severe gastrointestinal issues, including gastroparesis (stomach paralysis), ileus (intestinal blockage), and nausea.
While the risk is low, it is considered severe. Some studies indicate that patients on these drugs may require longer fasting periods (e.g., 24+ hours or stopping the medication for a week) to reduce the risk of aspiration.
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Case Study – Close to the nerve decay but still OK!