Anesthesia
We Offer Several Methods of Anesthesia
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.
To administer general anesthesia in the office, an oral and maxillofacial surgeon must have completed a minimum of three months of hospital-based anesthesia training, and our doctors have done more than this minimal requirement. Dr. Scott and Dr. Simpson both participated on the anesthesia service at U.T. Southwestern as a component of their training. At a minimum, qualified applicants will then undergo an in-office evaluation by a state dental board appointed examiner. The examiner observes an actual surgical procedure during which general anesthesia is administered to the patient. The examiner also inspects all monitoring devices and emergency equipment and tests the doctor and the surgical staff competence on anesthesia related emergencies. If the examiner reports successful completion of the evaluation process, the state dental board will issue the doctor a license to perform general anesthesia. The license must be renewed at least every five years and requires the doctor to maintain the required amount of continuing education units related to anesthesia.
Stonebriar Facial and Oral Surgery takes their commitment to anesthesia excellence very seriously. They have been evaluated by the Texas State Board of Dental Examiners, the Texas State Board of Medical Examiners, and the Texas Society of Oral & Maxillofacial Surgeons. Truly, they have left no stone unturned for your safety.
Comfort Is Our Priority
Again, when it comes to anesthesia, our priority is the patient’s comfort and safety. If you have any concerns regarding the type of anesthesia that will be administered during your oral surgery procedure, please do not hesitate to discuss your concerns with your doctor at the time of your consultation.
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.
USUAL INDICATIONS: 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 of the procedure being performed. While the patient is asleep, they remain breathing on their own without assistance. Supplemental oxygen is delivered through a nasal canula, and the patient’s vital signs are closely monitored.
USUAL INDICATIONS: 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.
Nitrous Oxide Sedation with Local Anesthetic
A mixture of nitrous oxide (laughing gas) and oxygen is administered through a nasal breathing apparatus. The patient remains conscious in a relaxed condition. Nitrous oxide has a sedative and analgesic (pain-controlling) effect.
USUAL INDICATIONS: Simple oral surgery procedures such as routine extractions or routine dental implants.
Hospital or Surgery Center Based General Anesthesia
A patient is admitted to a hospital or surgery center where anesthesia is administered by an anesthesiologist. The patient is intubated and requires mechanical assistance for breathing by a ventilator.
USUAL INDICATIONS: Indicated for patients undergoing extensive procedures such as face and jaw reconstruction and TMJ surgery. Also indicated for patients with severe medical conditions.
How is the IV Sedation Administered?
An IV catheter is started, typically in the hand or arm. IV fluids are administered and the medications are delivered through the IV line. Some patients with medical conditions and/or on specific drug regimens may only be lightly sedated.
The goal of IV sedation is to use as little medication as possible to get the treatment completed. Dr. Scott and Dr. Simpson titrate the drug to effect, which means every patient will receive different amounts of medicine and will be treated differently to their own very specific needs. It is very safe, much safer than oral sedation. With IV sedation a constant “drip” is maintained via the intravenous tube.
At any time, an antidote can be administered to reverse the effects of the medications if necessary. Along with IV sedation there are also other different “levels” of sedation available to you in our office.