Anestesia

Several methods of anestesia están disponibles. 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.

Opciones de anestesia

The following table illustrates the choices of anesthesia, a description of the anesthetic technique, and the usual indications for that technique.

• MethodTypes of Anesthesia
  Description of Technique
  Usual Indications
• Method Local Anesthetic
  Description of Technique The patient remains totally conscious throughout the procedure. A local anesthetic (p.ej. 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 Anesthetic
  Description of Technique A mixture of nitrous oxide (gas de la risa) and oxygen is administered through a nasal breathing apparatus. The patient remains conscious in a relaxed condition. Nitrous oxide has a sedative and analgesic (dolor- controlling) effect.
  Usual Indications Simple oral surgery procedures to more involved procedures such as removal of wisdom teeth and placement of implantes dentales.
• 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 Anesthesia
  Description 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 anestesia general in the office, a periodontist 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.

Otra vez, 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.

sedación intravenosa (“Twilight Sedation”)

Our office offers our patients the option of sedación intravenosa or Dental Intravenous Anesthesia or to some it is referred to as “Twilight Sedation” for their dental treatment. Intravenous Sedation or “twilight sleep” helps you to be comfortable and calm when undergoing dental procedures. Your treatment can be completed under intravenous sedation. Intravenous sedation or “IV sedation” (twilight sedation) is designed to better enable you to undergo your dental procedures while you are very relaxed; it will enable you to tolerate as well as not remember those procedures that may be very uncomfortable for you. IV sedation will essentially help alleviate the anxiety associated with your treatment. You may not always be asleep but you will be comfortable, calm and relaxed, 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?

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. 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. 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 “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. There is nitrous oxide analgesia.

Óxido nitroso (Gas de la risa)

Óxido nitroso is a sweet smelling, non irritating, gas incoloro que se respira. El óxido nitroso ha sido el principal medio de sedación en odontología durante muchos años.. El óxido nitroso es seguro; el paciente recibe 50-70% oxígeno con no menos de 30% óxido nitroso. 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.

Existen muchas ventajas al usar óxido nitroso

• La profundidad de la sedación puede modificarse en cualquier momento para aumentar o disminuir la sedación..
• No hay un efecto posterior como un “resaca”.
• La sedación por inhalación es segura, sin efectos secundarios en el corazón y los pulmones., etc.
• La sedación por inhalación es muy efectiva para minimizar las náuseas..
• Funciona rápidamente cuando llega al cerebro dentro 20 segundos. In as few as 2-3 minutos desarrolla sus propiedades relajantes y analgésicas.

Reasons to Not use Nitrous Oxide

Though there are no major contraindications to using nitrous oxide, es posible que no desee usarlo si tiene enfisema, problemas exóticos en el pecho, EM., un resfriado u otras dificultades para respirar. Es posible que desee pedirle a su dentista un “5 juicio minuto” para ver cómo se siente con este tipo de método de sedación antes de continuar.