Types of Anaesthesia
Anaesthesia as an outpatient in our office can vary from local anaesthesia to true general anaesthesia.
- Local anaesthesia (Freezing)
- Intravenous Sedation (Neurolept anaesthesia): Partially Conscious
- General anaesthesia (Fully Asleep)
Oral and maxillofacial surgeons are unique among the surgical specialties with regards to anaesthesia training. Every Oral and maxillofacial surgeon during their residency receives formal anaesthesia training with the department of anaesthesia in the hospital. They are taught the skills to safely administer anaesthesia to patients. This includes I.V. sedation, general anaesthesia, airway management and intubation techniques. This also includes complete training in Advanced Cardiac Life Support. Most provinces have very strict guidelines regarding the administration of anaesthesia in the office to ensure patient safety. We, as most oral and maxillofacial surgeons, follow the guidelines and protocols set forth by our provincial medical (College of Physicians and Surgeons of Alberta ) and dental regulatory body (Alberta Dental Association). By doing so, our office is regularly inspected. We maintain a non-hospital certification with the College of Physicians and Surgeons of Alberta. All office staff at Kingsway Oral & Maxillofacial Surgery are certified in CPR.
The oral and maxillofacial surgeons at Kingsway Oral & Maxillofacial Surgery have advanced training in all aspects of anaesthesia and emergency care. The surgeons usually work in concert with medical anesthesiologists. Kingsway Oral & Maxillofacial Surgery Suite is unique in that it has full-time fellowship trained medical anesthesiologists working in the facility five days per week. A medical anesthetist is a medical doctor who has completed all the training required for medical practice and then devotes another 4 years of specialized training to the specialty of anesthesiology including regional blocks, sedation, and general anaesthesia. All the anesthetists providing services at Kingsway Oral & Maxillofacial Surgery are also involved with more complicated surgical cases at the local regional hospitals. This commitment has provided our patients with highest standards of care and availability of the latest techniques and drugs since the first general anesthetic at Kingsway Oral & Maxillofacial Surgery in 1972. It is our utmost goal to make your surgical experience as pleasant and stress free as possible while maintaining the highest levels of safety.
Many patients can have their procedures completed using a local anesthetic to “numb” the area. For those people wishing to be sedated so that they are unaware of the surgery, IV sedation is offered. Ambulatory anaesthesia is the administration of medications in the office that induce either general anaesthesia where the patient is totally asleep or sedation where the patient is in a semi-conscious state. All forms of IV sedation and General anaesthesia are administered by fellowship trained medical anaesthesiologist and/or an oral and maxillofacial surgeon.
During the initial consultation you and your oral surgeon will discuss the type of procedure involved, your medical history and your level of anxiety. Some procedures do to their nature require the use of general anaesthesia or IV sedation, whereas others are best accomplished under local anaesthesia. The choice of anaesthesia is always a personal decision and should be made only after an informative consultation with the oral and maxillofacial surgeon. In addition, during the initial consultation, you will also be given instructions to prepare for surgery such as: wearing loose warm and comfortable clothing, not having anything to eat after midnight and clear fluids (i.e. pop) up to 4 hours prior to surgery, taking all of your regular medications, bringing an escort with you and making arrangements for you recovery at home (preoperative instructions).
Although most of the more modern anesthetic medications are kind to the stomach and do not produce nausea, occasionally just the anxiety that one has about having surgery can generate a queasy feeling in ones stomach. A patient who becomes sick with a full stomach could present a potentially dangerous scenario of choking. Therefore, it is important to follow all pre-operative instructions. The medications used for sedation do persist in the blood stream for up to 24 hours. Therefore it is understated that you WILL NOT operate a vehicle or operate machinery for 24 hours after being sedation or general anaesthesia.
Our anaesthesiologists are also available to answer any specific questions you may have in regards to the anaesthetic. The benefits of general anaesthesia and/ or intravenous sedation include a decrease in anxiety and awareness during the surgery. This translates into near or total amnesia of the procedure, lack of noise perception and no pain. During the procedure it is important to note that patients are still given local anesthetic to “numb” the area or partially sedated may also feel occasional pressure.
Coming to Kingsway Oral & Maxillofacial Surgery for the day of surgery and anaesthesia is no different than having surgery in your own hospital and it is often much more user friendly. The equipment in our surgical suites and recovery room are the same as those used in the hospitals. When you arrive in the surgical suite the nurse or dental assistant will connect you to a number of monitors and the anesthetist will start an intravenous. Safe anaesthesia demands the use of several noninvasive monitors that we attach to you. These devices are typically a blood pressure cuff, an EKG (electrocardiogram) and a pulse oximeter (a device that measures the amount of oxygen in your blood). Therefore, it is suggested that you wear loose clothing to facilitate the application of these important devices. Routinely drugs will be injected into the intravenous to cause you to relax or sleep. If you have serious fear of needles, we can use gas to put you to sleep and an intravenous will be in place when you wake up. Once you are asleep, the anaesthetist will insert a breathing tube through your nose and into you windpipe. This protects the airway and allows the surgeon unrestricted access to the mouth. This tube will be gone by the time you wake up on a stretcher in the recovery room. Once you are able to sit up and drink fluids, the intravenous will be removed and you are almost ready to leave. At this time the recovery room nurse will review with you and your ride all the post-operative instructions and answer any questions either of you may have in regards to care of your mouth. There is always a surgeon on-call and he can also answer any emergency questions you may have in regards to your care following your surgery.