Anaesthesia

Board Certified Oral and Maxillofacial Surgeons are unique in the health professional field, in that they are trained in all aspects of anesthesia administration.  Oral and Maxillofacial surgeons train with anesthesiologists during their residency. No other dental specialty requires this level of training nor obtain this kind of training from the Department of Anesthesiology. This intensive training and experience gives the oral and maxillofacial surgeon the ability to provide patients with safe, effective outpatient anesthesia that has distinguished the specialty of oral surgery since its earliest days. Their expertise makes it possible to provide you the sedation and anesthesia for the complex surgery to be performed in the office setting with little or no discomfort. During the 4 to 6 year residency, oral surgeons are involved in administering intravenous or IV sedation, general anesthesia, oral sedation, emergency airway management, intubation techniques, starting IVs, and monitoring the patients during sedation or anesthesia. Our surgeons at Pacific Coast Oral and Maxillofacial Solutions are certified in Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), and Acute Trauma Life Support (ATLS) in addition to the basic Cardiopulmonary Resuscitation/Basic Life Support (CPR/BLS). We follow the strict guidelines set forth by the College of Dental Surgeons of British Columbia. Our facility is one of the few to receive accreditation to administer all levels of sedation and anesthesia. It is recognized as a full surgical facility that can provide general anesthesia in the outpatient setting. We also have Critical Care-trained Registered Nurses that help take of you and monitor you in the Post-Anesthesia Care Unit (PACU). Our priority is the safety and comfort of our patients.

During the initial visit you and Dr Aidelbaum or Chen will discuss the type of procedure involved, your health and your level of anxiety.  Based on your concerns and their recommendations we will determine the best type of anaesthesia for you.

YOUR FIRST VISIT & WHAT TO EXPECT

For many patients, they have extreme anxiety associated with dentistry or surgery. Many of them wish to be sedated so that they are unaware of the surgery. Dr. Aidelbaum and Dr. Chen will answer any questions you might have and together, you will decide with your surgeon what type of anesthesia you desire. The level of anesthesia will be tailored to each individual as well as will vary according to the surgical procedure, medical history and your level of anxiety. Please bring a list of your mediations and your medial doctor’s information. Dr. Aidelbaum and Dr. Chen can then thoroughly evaluate your health in preparation of the surgery and anesthesia. They will also explain how the sedation and anesthesia will work. Many patients will find in-office surgeries and sedation less complicated and have a shorter recovery time. The state-of-the-art monitoring equipment used at Pacific Coast Oral and Maxillofacial Solutions are similar to what the hospital uses in same day surgery. Our staff and doctors will also give you pre-operative instructions on how to prepare for surgery and anesthesia.

BENEFITS OF ANESTHESIA

Dr. Aidelbaum and Chen are available to answer questions about anesthesia. There are numerous benefits of general anesthesia/intravenous sedation including:

  • eliminates your anxiety and pain
  • near or total amnesia of the procedure
  • lack of noise perception
  • no pain or discomfort
  • no pressure sensations
  • ability to accomplish more high-quality surgery in less time
  • benefits patients with sensitive gag reflex or difficulty sitting in chair for extended periods
  • sense of well-being during procedure and after the procedure

What to Expect

Undergoing intravenous anesthesia and surgery in our office is similar to having surgery and anesthesia at a hospital same day surgery facility. However, most patients describe in-office surgery and anesthesia less complicated and have a shorter recovery time versus hospital day surgery. The same equipment is used in our surgical facility as the hospital. After you check in at the front desk, you will be taken to the surgical suite where another nurse or surgical assistant will ask you some more “checking-in” questions to verify the procedure, review of medical history, and pre-sedation instructions. Our nurse or surgical assistant will place a number of monitors including an automatic blood pressure cuff, an electrocardiogram(EKG), a pulse oximeter(a device that measures oxygen in your blood). We will start a small intravenous line for you that will allow administration of fluids and medications to relax you. Once you are “sleep” and uncomfortable, the local anesthetic will be given unbeknowngst to you. When the surgery is finished, most of our patients are completely unaware that the procedure has already been performed. Our patients are “frozen” so they are not in any pain. At this time you will be transferred to the recovery room or so-called post-anesthesia recovery suite. A nurse will watch over you until you meet the discharge criteria. You will then be discharged to the care of your escort. The nurse will review with you and your escort all the post-operative instructions.

Our priority is the safety and comfort of our patients

During the initial consultation you and Dr. Aidelbaum or Dr. Chen will discuss the type of procedure involved, your medical history and your level of anxiety. Some procedures due 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.

 

Anesthesia Choices

Local Anesthesia:

Administration of local anesthesia by injection numbs the surgical site and the adjacent area. You will be fully aware of the procedure, including the vibrations, sounds, and pressure sensations associated with the surgery that may be somewhat annoying, but it will not hurt. This is the way most procedures are done in your dentist’s office.

Intravenous sedation:

Medication is administered in intravenously to sedate you to the point that you will probably keep your eyes closed during the procedure, but will respond to verbal instructions and may know what is going on. In all likelihood you will remember very little, if anything at all. You must come in on a completely empty stomach and someone must drive you to and from your appointment and remain in the office during your surgery. Someone must remain with you all day following your surgery
Deep Intravenous Sedation: You are not paralyzed or intubated. Medication is administered intravenously to sedate you to the point that you will probably keep your eyes closed during the procedure and may not respond to verbal instructions. You will not really know what is going on and in all likelihood you will not remember your surgery. You must come in on a completely empty stomach and someone must drive you to and from your appointment and remain in the office during your surgery. Someone must remain with you all day following your surgery.

General Anesthesia:

General anesthesia affects the entire body and makes the person unconscious. The unconscious person is completely unaware of what is going on and does not feel pain from the surgery or procedure. General anesthesia medications can be injected into a vein or inhaled.

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.

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.

You must come in on a completely empty stomach and someone must drive you to and from your appointment and remain in the office during your surgery. Someone must remain with you all day following your surgery.

If you have any questions regarding the above information, please don’t hesitate to ask. As a general recommendation for your anesthetic choice, choose the option with which you are the most comfortable.

 

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