A DOCS Education Gold Member asks:
We are trying to decide what to give the patient the night before her sedation. The patient states that she cannot take Valium because it makes her sick, but she can take Ativan (lorazepam). What do you suggest the patient take the night before sedation?

Dr. Anthony S. Feck, DOCS Education Dean of Faculty, responds:

If the patient truly cannot take diazepam, then I wouldn't have them take anything the night before. Lorazepam is too efficacious, decreasing the safety margin for pre-operative sedation.

The DOCS Member asks a follow-up question:
Thank you! What about having the patient take a Lorazepam 1 hour before her appointment?

Dr. Feck responds:
If you can do an incremental protocol, then taking a lorazepam loading dose is part of incremental protocols #3 and #4 (see your course workbook). If the patient can take triazolam, I would use a triazolam incremental protocol, which would be triazolam as the loading dose.

If you cannot do an incremental protocol, then a loading dose before the appointment on the day of the appointment is not allowed.

The information contained in this, or any case study post in Incisor should never be considered a proper replacement for necessary training and/or education regarding adult oral conscious sedation. Regulations regarding sedation vary by state. This is an educational and informational piece. DOCS Education accepts no liability whatsoever for any damages resulting from any direct or indirect recipient's use of or failure to use any of the information contained herein. DOCS Education would be happy to answer any questions or concerns mailed to us at 106 Lenora Street, Seattle, WA 98121. Please print a copy of this posting and include it with your question or request.
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