Office Based Anesthesia
Oral and maxillofacial surgeons are unique in that they have received formal training in anesthesia. This training is an integral part of their residency through the department of anesthesiology of their hospital system. This includes everything from starting an IV to advanced cardiac life support (ACLS). Certification in ACLS helps maintain the highest standard of care in the office setting.
Your initial consultation is very important to your overall treatment plan. Our doctors will discuss the specifics of your exam and the surgical procedures that may need to be performed. They will also review your medical history and evaluate your anesthetic needs and risks. The anesthetic may vary from a local anesthetic to what is considered a general anesthetic. After the course of anesthesia is decided, you will be given specific instructions either by the doctor or the trained office staff.
The choice of anesthesia is between the patient and the doctor. It is best made after an informative consultation. You will be given specific preoperative instructions, which usually includes:
- Having nothing to eat or drink for 8 (eight) hours before your surgery
- Wearing loose and comfortable-fitting clothing
- No facial make-up
- Removal of nail polish or fake nails
- Instructions on taking any medications prescribed by the doctor or your physician
- Have someone responsible with you to take you home and watch over you for the rest of the day following your surgery
Undergoing intravenous anesthesia and surgery at our office is similar to having surgery and anesthesia at a hospital day surgery facility. Our facility uniquely offers an Ambulatory Surgery Center (or ASC) level of care. This allows our surgeons to perform more advanced surgeries such as facial trauma, orthognathic or jaw surgery and advanced dentoalveolar or dental implant procedures in an office setting.
You will be monitored with similar equipment as in a day surgery or hospital setting. Once you are taken to the surgical suite, one of our trained surgical assistants will place a number of monitors to help safely perform anesthesia; these include an automatic blood pressure monitor, an electrocardiogram, capnography and a pulse oximeter. This is why loose, comfortable clothing is required.
An intravenous (IV) catheter is usually placed. This is for the administration fluids and medications for anesthesia. Our facility as an ASC can also allow use of inhalational agents so that placement of the IV catheter can be done after you have been sedated. You will receive oxygen via a nasal cannula or face mask that fits comfortably. Most patients receive a combination of medications which may include Versed (a benzodiazepine), Fentanyl (a narcotic), among other medications. Also, medications may be used to decrease swelling, prevent nausea, and/or to help dry salivary flow. Once you are sedated, a local anesthetic will be administered. Usually we use a combination that will include a long-acting agent that may keep your mouth numb for 4-8 hours or longer.
After surgery you will be allowed to recover (wake-up) for a period of time. While you are recovering, your vital signs will be monitored. Once you are stable and awake, you will be discharged to the care of your ride home. Because of the medications used, you should not attempt to perform any dangerous or strenuous activities such as driving or operating machinery for at least 24 hours after surgery.