Anesthesia Options, Oral Surgery
Several methods of anesthesia are available. The method of anesthesia that is chosen for or by a patient depends upon the nature of the surgical procedure and the patient’s level of apprehension. The following table illustrates the choices of anesthesia, a description of the anesthetic technique, and the usual indications for that technique.
|Method of Anesthesia||Description of Technique||Usual Indications|
|Local Anesthetic||The patient remains totally conscious throughout the procedure. A local anesthetic (e.g. lidocaine) is administered in the area where the surgery is to be performed. Local anesthetic is used in conjunction with the other methods of anesthesia in all oral surgery procedures.||Simple oral surgery procedures such as minor soft tissue procedures and simple tooth extractions.|
|Office Based General Anesthesia with Local Anesthetic*||Medications are administered through an intravenous line (I.V.). The patient falls asleep and is completely unaware from the beginning of the procedure being performed. This is when local anesthetic is administered. Most people remember nothing from the surgery, but some patients will drift in and out of a twilight sleep. However they are comfortable, calm and feeling no pain and no anxiety. Medications most commonly used are Fentanyl (opiate), Versed (benzodiazepine), Ketamine, and Diprivan. Supplemental oxygen is delivered through a nasal breathing apparatus and the patient’s vital signs are closely monitored.||General anesthesia is available for all types of oral surgery. A patient may choose general anesthesia for simple procedures depending on their level of anxiety. Most people having their wisdom teeth removed or having a dental implant placed will choose general anesthesia. General anesthesia may be necessary if local anesthesia fails to anesthetize the surgical site which often occurs in the presence of infection.|
|Hospital or Surgery Center Based General Anesthesia||A patient is placed to sleep with the help of an anesthesiologist. Depending on the patient’s health and the type of surgery this can often be done in our office’s surgical center. However, in some cases patients are taken to a hospital for extensive surgery or complex medical management.||Indicated for patients undergoing extensive procedures such as face and jaw reconstruction and TMJ surgery. Also indicated for patients with medical conditions such as heart disease or lung disease who require general anesthesia.|
To administer general anesthesia in the office, an oral surgeon must have completed at least three months of hospital based anesthesia training. Dr. Porter and Dr. Doles have gone above this requirement and undergone extensive hospital-based anesthesia training in addition to continuing education. Your safety and comfort are our number one priority.
When it comes to anesthesia, we are dedicated safety, quality and comfort. If you have any questions regarding the type of anesthesia that will be administered during your oral surgery procedure, please do not hesitate to discuss with your doctor at the time of your consultation.
How is the IV Sedation Administered?
A thin needle will be introduced into a vein in your arm or hand. The needle will be attached to an intravenous tube through which medication will be given to help you relax and feel comfortable. Once again some patients may be asleep while others will slip in and out of sleep. Some patients with medical conditions and/or on specific drug regimens may only be lightly sedated and may not sleep at all.
The goal of IV sedation is to use as little medication as possible to get the treatment completed. It is very safe, much safer than oral sedation. With IV sedation a constant control is maintained via the intravenous tube. At any time an antidote can be administered to reverse the effects of the medications if necessary.
In-House Surgical Suite
For patients with difficult teeth or complex medical histories, we can safely treat them in our state-of-the-art outpatient operating room, which is attended by a board certified anesthesiologist affiliated with a local hospital group.
This means we rarely have to take patients to a traditional hospital. Most patients and parents find that our office provides a more comfortable and less stressful environment than a traditional hospital setting.