General Anesthesia and Sedation
- May 16, 2013
Private Dental Hospital
Along with a ten bed capacity, we have a fully equipped operation room in our hospital where we perform both surgical procedures with general anesthesia or sedation (tooth extraction, gingival treatments, implant procedures, bone cyst operations, bone graft operations etc.) and nonsurgical treatments (fillings, root canal treatment, etc.).
What is sedation?
The patient is relaxed with the combination of some sedatives (Diazem like) and narcotic analgesics (morphine like), along with a hypnotic medicine on some occasions. A short period of amnesia (loss of memory) is induced and dental treatment is carried out rapidly under local anesthesia.
What is general anesthesia?
Known as Narcosis among people, General Anesthesia is induced with a combination of three medicines:
- Temporary loss of consciousness due to hypnotic medicines
- A painless operation due to narcotic analgesics (morphine like) even tough the patient is unconscious
- Muscle relaxants (Curare) relax all the muscles and provide a comfortable surgery. All the muscles including the respiratory ones are paralyzed temporarily with muscle relaxants. The respiration is maintained by a small sterile tube named “endotracheal tube” that is placed into the respiratory tract (trachea) along with an anesthesia device (respiratory device) under the surveillance of an anesthesiologist.
Continuity of the general anesthesia is maintained by the inhalation of oxygen/air or oxygen/air/nitrous oxide combination or with volatile agents (Sevorane etc).
Complications of Anesthesia
Due to innovations in medicine, side effects of drugs used in anesthesia are few and these drugs are eliminated from the body rapidly. Owing to the current medical technology, all vitals of a patient can be observed closely with anesthesia devices or through patient monitoring. For these reasons, with experienced doctors and under appropriate conditions, complications due to anesthesia (general anesthesia or sedation) are very few. But what every anesthesiologist fears the most is when the patient is satiated before the operation. If the satiated patient vomits under general anesthesia and the vomit pass to lungs through respiratory tract, this could lead to pneumonia, a condition that is severe and fatal. Therefore the patients are required to be fasting for at least 8 hours prior to surgery. The first rule of minimizing complications is to do the preoperative anesthesia examination in detail.
Patients applying to our hospital have their treatments planned in related departments and then they are examined for anesthesia preoperatively. During anesthesia examination, a detailed history (operations done in the past, past diseases, regularly used drugs etc.) of a patient is recorded and physical examination is carried out. After completing the necessary examinations, operation date is determined.
Risk groups for anesthesia
ASA-I: A normal healthy patient, with minimum risk.
ASA-II: A patient with a mild systemic disease like diabetes or hypertension whose vital functions are not affected by the disease.
ASA-III: A patient with a severe systemic disease like a heart deficiency or a respiratory deficiency whose vital functions are affected by the disease, this is a high risked group.
ASA-IV: A patient with a severe systemic disease that is a constant threat to life like severe heart, liver, kidney or respiratory deficiencies.
Patient groups suitable for general anesthesia and sedation:
ASA-I and ASA-II, adult and infant patients can be considered in 5 groups:
- Infants aged under 4 – Dental treatment through persuasion is difficult in these patients.
- Infants or adults with developmental deficiencies
- Adult patients with advanced phobia (fear)
- Surgical operations that necessitate general anesthesia (bone grafting, bone cysts etc.)
A patient group demanding several surgical procedures completed in a short period of time (2-3 hours) under general anesthesia that cannot be performed under local anesthesia with a single operation