Several methods of anesthesia có sẵn. 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.
MethodTypes of AnesthesiaDescription of TechniqueUsual Indications
Method Local AnestheticDescription of Technique The patient remains totally conscious throughout the procedure. A local anesthetic (Ví dụ như. 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.
Method Nitrous Oxide Sedation with Local AnestheticDescription of Technique A mixture of nitrous oxide (Laughing khí) and oxygen is administered through a nasal breathing apparatus. The patient remains conscious in a relaxed condition. Nitrous oxide has a sedative and analgesic (nỗi đau- controlling) effect.Usual Indications Simple oral surgery procedures to more involved procedures such as removal of wisdom teeth and placement of dental implants.
Method Office Based General Anesthesia with Local Anesthetic*Description of Technique Medications are administered through an intravenous line (I.V.). The patient falls asleep and is completely unaware of the procedure being performed. 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.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.
Method Hospital or Surgery Center Based General AnesthesiaDescription of Technique A patient is admitted to a hospital or surgery center where anesthesia is administered by an anesthesiologist.Usual Indications 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 anesthesiain the office, an oral surgeon must have completed at least three months of hospital based anesthesia training. 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 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 is renewable every two years if the doctor maintains the required amount of continuing education units related to anesthesia. Một lần nữa, when it comes to anesthesia, our first 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.
Tiêm tĩnh mạch an thần (“Chạng vạng an thần”)
Our office offers our patients the option of Tiêm tĩnh mạch an thần or Dental Intravenous Anesthesia or to some it is referred to as “Chạng vạng an thần” để điều trị Nha khoa. Intravenous Sedation or “Chạng vạng ngủ” giúp bạn được thoải mái và bình tĩnh khi trải qua các thủ thuật Nha khoa. Your treatment can be completed under intravenous sedation. Intravenous sedation or “Việc gây tê IV” (Chạng vạng an thần) được thiết kế để tốt hơn cho phép bạn để trải qua các thủ thuật Nha khoa của bạn trong khi bạn đang rất thoải mái; it will enable you to tolerate as well as not remember those procedures that may be very uncomfortable for you. Việc gây tê IV về cơ bản sẽ giúp làm giảm bớt những lo lắng liên quan đến điều trị của bạn. Bạn có thể không luôn luôn ngủ nhưng bạn sẽ được thoải mái, Bình tĩnh và thoải mái, drifting in and out of sleep – a “twilight sleep”. If you choose the option of intravenous sedation your IV sedation/anesthesia is administered and monitored by the doctor therefore eliminating the costly expense of having your treatment carried out in an operating room or same day surgical facility.
How is the IV sedation administered?
Một cây kim mỏng sẽ được giới thiệu vào tĩnh mạch ở cánh tay hoặc bàn tay của bạn. Kim sẽ được gắn với một ống tiêm tĩnh mạch, qua đó loại thuốc sẽ được đưa ra để giúp bạn thư giãn và cảm thấy thoải mái. At times a patient’s vein may not be maintainable, in these situations the medications will be administered and the needle retrieved – both scenarios will achieve the same desired level of conscious sedation. Một lần nữa một số bệnh nhân có thể ngủ trong khi những người khác sẽ trượt vào và ra khỏi giấc ngủ. Một số bệnh nhân với điều kiện y tế và/hoặc vào loại thuốc cụ thể phác chỉ có thể được gây mê nhẹ và có thể không ngủ ở tất cả. Mục đích của việc gây tê IV là sử dụng như là thuốc ít nhất có thể để có được điều trị hoàn thành. It is very safe, much safer than oral sedation. With IV sedation a constant “drip” is maintained via the intravenous tube. Bất cứ lúc nào một thuốc giải độc có thể được quản lý để đảo ngược những ảnh hưởng của các loại thuốc nếu cần thiết. Along with IV sedation there are also other different “levels” of sedation available to you in our office. There is nitrous oxide analgesia.
Nitơ oxit (Laughing Gas)
Nitơ oxit is a sweet smelling, non irritating, colorless gas which you can breathe. Nitrous Oxide has been the primary means of sedation in dentistry for many years. Nitrous oxide is safe; the patient receives 50-70% oxygen with no less than 30% nitrous oxide. Patients are able to breathe on their own and remain in control of all bodily functions. The patient may experience mild amnesia and may fall asleep not remembering all of what happened during their appointment. There are many advantages to using Nitrous Oxide
- The depth of sedation can be altered at any time to increase or decrease sedation.
- There is no after effect such as a “hangover”.
- Inhalation sedation is safe with no side effects on your heart and lungs, vv.
- Inhalation sedation is very effective in minimizing gagging.
- It works rapidly as it reaches the brain within 20 seconds. In as few as 2-3 minutes its relaxation and pain killing properties develop.
Reasons to Not use Nitrous Oxide
Though there are no major contraindications to using nitrous oxide, you may not want to use it if you have emphysema, exotic chest problems, M.S., a cold or other difficulties with breathing. You may want to ask your dentist for a “5 minute trial” to see how you feel with this type of sedation method before proceeding.