Before Intravenous Anesthesia SedatioN
Our goal is to provide you with a safe, pleasant, and effective anesthetic. In order to do this, it is imperative that we have your full cooperation with these important instructions regarding your anesthesia. You may not have anything to eat or drink (including water) for eight (8) hours prior to the appointment.
- No smoking at least 24 hours before surgery. Ideally, cut down or stop smoking as soon as possible prior to the day of surgery.
- A responsible adult must accompany the patient to the office, remain in the office during the procedure, and drive the patient home.
- The patient should not drive a vehicle or operate any machinery for 24 hours following the anesthesia experience.
- Please wear loose fitting clothing with sleeves which can be rolled up past the elbow, and low-heeled shoes.
- Contact lenses, jewelry, and dentures must be removed at the time of surgery.
- Do not wear lipstick, excessive makeup, or nail polish on the day of surgery.
- If you have an illness such as a cold, sore throat, stomach or bowel upset, please notify the office two (2) days prior to the procedure.
- If you take routine oral medications, please check with Dr. Benjamin Foley and Dr. Thao Le prior to your surgical date for instructions.
IMPORTANT INSTRUCTIONS REGARDING ANESTHESIA
In addition to local anesthesia, your surgeon may recommend, or you may request, an additional type of anesthesia. Each anesthetic option requires important preparation on your part. For your safety, it is important that you read and carefully follow the instructions on this page. If you have any questions regarding this information, please ask your surgeon prior to your procedure.
For all surgery, please wear comfortable, loose-fitting clothing. Tops/shirts should have sleeves that are easily drawn up above the elbow. Please remove nail polish before surgery, and apply as little makeup as possible. Women of child-bearing age may be asked to provide a urine specimen on arrival for a pregnancy test.
Local anesthesia will produce “numbness” (loss of sensation) in the area of the operation. If only local anesthesia is used, you will be awake and recall the surgery, but there should be no significant discomfort. Depending on the type of local anesthetic administered the “numbness” may persist for as long as 8 hours. Do not attempt to chew any food until all of your oral and lip sensations have returned. Rarely, local anesthetic injection can cause permanent injury to nerves with alteration in sensation (numbness, tingling, burning, pain) in the tongue, lip, chin, and gum tissues.
NITROUS OXIDE GAS:
Nitrous oxide is also known as “laughing gas.” You will be relaxed and somewhat less aware of your surroundings, but will recall all of the procedure. Local anesthesia is always used in conjunction with nitrous oxide.
- You may have a light meal four (4) hours prior to surgery.
- It is preferable to have someone drive you home after your surgery.
- Plan to rest at home for the remainder of the day.
INTRAVENOUS (I.V.) MODERATE, DEEP AND GENERAL SEDATION:
Medications are given through a vein in your arm or hand that will produce a state of profound relaxation. With moderate sedation you will be conscious but profoundly relaxed. You may have some awareness of your surroundings and the procedure (voices and other sounds, manipulation of your mouth, etc.). Generally, moderate sedation (formerly known as “conscious sedation”) is a pleasant experience. Although you will not be unconscious, there will be very little recall of the events surrounding surgery. You will continue to breathe spontaneously and protect your airway.
General sedation medications are also administered intravenously. General sedation provides a deeper level of sedation than moderate sedation. You will have no recall of the surgery and usually have a longer recovery time in the office. General sedation is well suited to the patient who is concerned that they may have some awareness of the events of their surgery under moderate sedation. During the sedation we may need to support your airway or breathing.
YOUR SAFETY IS OUR PRIORITY: In the event that we feel that a patient is not adequately sedated after receiving age and weight appropriate doses of medications, we may not proceed with the procedure and recommend that the procedure be re-scheduled in the operating room.
During your I.V. anesthetic you will be very closely monitored by a staff of trained doctors and assistants. Monitoring will routinely involve continuous measurement of the oxygen content in your blood (pulse oximetry), blood pressure, heart rate, heart tracing (ECG) and concentration of CO2 (carbon dioxide) in expired air.
IMPORTANT INSTRUCTIONS REGARDING YOUR I.V. ANESTHESIA
- Do not eat/drink any food or liquids eight (8) hours prior to your appointment time. This includes water. However, it is important that you take any regular medications (high blood pressure, antibiotics, etc.) or any pre-medication prescription that we have prescribed, with a small sip of water.
- You MUST have an adult accompany you to the appointment, wait for you during the procedure, and drive you home.
- Plan to rest for the remainder of the day. Do not drive, operate power tools, machinery, etc., or make important decisions for at least 24 hours after surgery.
- A responsible adult should be available immediately to assist you for at least four (4) hours after you return home. You are not to be at home alone for at least 4 hours after your surgery.
MOST COMMON MISUNDERSTANDINGS REGARDING ANESTHESIA:
- Patient arrives without an adult escort: Unless an adult can be available within 10 minutes of your scheduled appointment, your surgery will have to be re-scheduled. We are not permitted to start a procedure without your “ride” physically present.
- Patient eats prior to appointment: It is dangerous to be sedated with a full stomach. If you have not followed the instructions above (see important instructions regarding your anesthesia) it is your responsibility to inform the nurses and surgeon so that we can provide you with the safest anesthetic.
- “I thought you were going to put me to sleep”: The goal of I.V. moderate sedation is to induce a state of profound relaxation–not loss of consciousness. Though many patients believe that they were asleep for their surgery, some patients will have a pleasant awareness of some aspects of the procedure. If you are concerned that you may have an unpleasant awareness of your surgery, please discuss this with your surgeon and request general anesthesia.
If you have any questions or concerns, please call our office . We are available 24 hours a day.
Thank you for trusting us with your oral and maxillofacial surgery needs.
Reproduced with permission by: Samuel J. McKenna, D.D.S., M.D., F.A.C.S
Any other use or duplication of this material by any other party requires the prior written approval of Samuel J. McKenna