A drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway, and spontaneous ventilation is adequate. Cardiovascular function is usually maintained.
Note: In accord with this particular definition, the drugs and/or techniques used should carry a margin of safety wide enough to render unintended loss of consciousness unlikely. Repeated dosing of an agent before the effects of the previous dosing can be fully appreciated may result in a greater alteration of the state of consciousness than is the intent of the dentist. Further, a patient whose only response is reflex withdrawal from a painful stimulus is not considered to be in a state of moderate sedation.
The following definition applies to the administration of moderate or greater sedation: titration – administration of incremental doses of a drug until the desired effect is reached. Knowledge of each drug’s time of onset, peak response, and duration of action is essential to avoid over-sedation. Although the concept of titration of a drug to effect is critical for patient safety when the intent is moderate sedation one must know whether the previous dose has taken full effect before administering an additional drug increment.