There’s a good deal of confusion about the subject of pain relief and sedation. Many physicians advertise that they offer “intravenous sedation” or “conscious sedation”. You should know that not all “intravenous sedation” or “conscious sedation” is the same. We are the only gynecology office in Western New York that is accredited office based surgery center. We have decades of experience in offering intravenous sedation in an office setting.
Choose the type of sedation you wish.
Many women don’t require any additional pain medication other than a local anesthetic agent we provide. Some women just want a “pill” to relax them prior to and during their procedure. At the other extreme are women who want to feel nothing and remember nothing of their experience. The point is that we all have different needs and fears – what’s unique about our practice is that we can accommodate your different requirements.
Here are some of the choices we offer.
- Oral medications—some women simply require oral medications. There’s no charge for these medications. We usually provide you with an oral sedative – such as Xanax or Valium – in combination with an oral narcotic – such Hydrocodone or Oxycodone. If you chose this method of sedation you’ll be issued prescriptions at your initial visit. We ask only that you have someone drive you to and from your appointment.
- Combination of Oral and intramuscular medications—Oral medications, while useful for many women, cannot provide the depth of sedation or pain relief of medications given by injection. For some women—especially those that wish to avoid “I.V.s” we offer an oral sedative that you would take an hour or two prior to your procedure followed by an intramuscular injection of a narcotic about 30 minutes before your procedure. There is a nominal charge for this form of conscious sedation. As with oral medications you’ll need to have someone drive you to and from your visit.
- Intravenous sedation—For women who wish to have a deeper level of sedation and pain relief we offer intravenous sedation. The advantage of intravenous sedation is that the drugs are almost immediately effective and wear off in a relatively short period of time. If you elect to have intravenous conscious sedation you can control the level of sedation—you just need to tell us how deeply sedated you wish to be. Some women just want “something to take the edge off” but prefer to be awake. Others want to be “out”—to have no memory and to feel nothing of the procedure. You get to determine what level of sedation you wish. We use a combination medications. Most often we use a combination of Versed (midazolam), which is a sedative, and fentanyl, a narcotic. Occasionally other medications may be required. Remember, that not all conscious sedation is the same! These drugs should only be used in accredited facilities with personnel who are specially trained in its use. There are many requirements with respect to licensing and training for an office to provide these medications—-ours is one of the very few offices in upstate New York that meets those requirements.
Advantages of Intravenous Sedation
The medications, since they are given intravenously can be carefully controlled
- You control the depth of sedation and pain relief
- The drugs work quickly—you can feel the effects within seconds of their administration
- The drugs also wear off quickly so that within 2 hours you’ll feel “normal”.
Disadvantages of Intravenous Sedation
- Compared to other forms of sedation and pain relief we offer, these are comparatively expensive. Although we try and control our costs (and yours) the credentialing, training, safety equipment and regulatory requirements make this form of conscious sedation more expensive than the others.
- You will need someone to accompany you to the office, remain here with you and drive you home. This is sometimes difficult—especially in situations where no one else is available to accompany you.
- It does involve an I.V! Many women are frightened at the thought of an intravenous line. We understand that fear. In general, these are very tiny needles—even smaller than the ones used to draw your blood.
We understand that all of us are different with respect to our ability to tolerate pain, discomfort and anxiety. It’s why we offer a variety of choices to accommodate your physical, emotional and financial needs. Please feel free to talk to one of our providers if you need guidance in selecting a choice that’s best suited to meet your needs.