Oral and maxillofacial surgeons are unique among the various surgical specialties with regards to anesthesia training. Every oral and maxillofacial surgeon receives formal anesthesia training within the Department of Anesthesiology at the hospital during their residency program. The didactic training and technical skills are taught to safely administer general anesthesia to patients. This includes training in venipuncture, intravenous sedation, general anesthesia, airway management, intubation techniques and emergency resuscitation. Certification in Advanced Cardiac Life Support is required.
During your initial consultation, Dr. Klausner will discuss the specifics of the surgical procedure, review your medical history and assess your level of anxiety as related to your upcoming surgery. Some procedures due to their nature require the use of general anesthesia or intravenous sedation, whereas others are most easily accomplished with local anesthesia. The choice of anesthesia is a personal decision and is best made after an informative consultation at our office. Following the consultation you will be given specific instructions in preparation for your surgery; nothing to eat or drink for six (6) hours prior to surgery, wear loose comfortable clothing, take all of your regular medications and to have an adult escort accompany you home following surgery.
Coming to our office for surgery performed under anesthesia is not different than having surgery at a local hospital, and is often far simpler with a shorter recovery time. The monitoring equipment in our surgical suites and recovery rooms is the same as those used in the hospital. Upon your arrival in the surgical suite, a trained surgical assistant will connect you to a number of monitors. These devices include an automated blood pressure cuff, an electrocardiogram and a pulse oximeter, which measures the amount of oxygen in your blood. Therefore, it is suggested that your wear loose clothing to facilitate the placement of these non-invasive monitors.
After a brief discussion with Dr. Klausner, an intravenous line will be started on the inside aspect of the forearm for the administration of the intravenous medications. All patients undergoing intravenous anesthesia will receive supplemental oxygen during their surgery in addition to the administration of a local anesthetic. Most patients will receive a combination of a tranquilizer, narcotic and induction agent to facilitate a state of altered consciousness or sleep. Additional medications may be given to reduce post-surgical swelling and to prevent the production of excess saliva during the planned surgery.
Following your surgical procedure, you will be awakened and transported to a quiet recovery room, where you will remain for approximately 30 minutes. During this time period your vital signs will be monitored and you may be given an antibiotic and/or analgesic for pain relief as the local anesthesia begins to wear off. The medications utilized during your intravenous anesthetic can remain in your bloodstream for up to 24 hours following surgery. You are therefore advised not to drive a vehicle or operate machinery for 24 hours following your anesthetic.
A Brief Review of Your Choices For Anesthesia
- Local Anesthesia involves an injection of “Novocaine” to provide complete numbness of the surgical site. Using a local anesthetic alone, the patient will remain completely alert and aware of his/her surroundings.
- A tranquilizer such as Triazolam or Valium may be given in addition to the local anesthetic to reduce the anxiety associated with the planned surgery. Please avoid a heavy meal prior to your visit and do not drive for 24 hours following surgery.
Nitrous Oxide Sedation
- This technique involves the administration of nitrous oxide (laughing gas) and oxygen given via a nasal mask. Clear nasal passages are required for this technique to be successful. Many patients report that they experience a significant reduction in the anxiety associated with their surgical procedure and an increase in their pain tolerance.
- This technique allows for a state of reduced consciousness, relaxation, stress reduction, amnesia and increased pain tolerance. In addition to the administration of local anesthesia and nitrous oxide sedation, medications are given through an intravenous catheter to accomplish the desired effect. The patient is to have nothing by mouth for six hours prior to the appointment. An adult must escort the patient home following surgery.
Intravenous General Anesthesia
- This anesthetic technique allows for the patient to be unconscious (asleep) during their surgical procedure. The patient will be unaware that they are having surgery and will have little or no recollection of the procedure. This is different from general anesthesia in the hospital setting in that a ventilator is not utilized and complete muscle relaxation is unnecessary. No food or drink is allowed for six hours prior to the procedure.
Please note that patients taking regular medications for heart conditions, high blood pressure, seizure disorders, thyroid disorders, gastric reflux, asthma, etc., should take their medications with a small amount of water even if it is within the six hour time frame prior to surgery.
For diabetic patients and those on anticoagulants or chronic immunosuppressants, please consult with your physician prior to scheduling your surgical appointment.
During your pre-surgical consultation, Dr. Klausner will review all of the available anesthetic options and suggest which technique is most appropriate for the planned surgical procedure.