Anesthesia as an outpatient in our office operating suite can vary from local anesthesia to true general anesthesia.
1. Local anesthesia (Freezing)
2. Intravenous Sedation (Neurolept Anesthesia): Partially Conscious
3. General Anesthesia (Fully Asleep)
Oral and maxillofacial surgeons are unique among the surgical specialties with regards to anesthesia training. Every oral and maxillofacial surgeon during their residency receives formal anesthesia training with the department of anesthesia in the hospital. They are taught the skills to safely administer anesthesia to patients. This includes IV sedation, general anesthesia, airway management and intubation techniques. This also includes complete training in Advanced Cardiac Life Support. Most states have very strict guidelines regarding the administration of anesthesia in the office to ensure patient safety. Dr. Cox, as most oral and maxillofacial surgeons, follows the guidelines and protocols set forth by our state regulatory body. He is certified by the state board of dentistry for outpatient anesthesia. All office staff are certified in CPR, and the surgical staff have received certification by the AAOMS.
Dr. Cox has advanced training in all aspects of anesthesia and emergency care. This commitment has provided our patients with highest standards of care and availability of the latest techniques and drugs. 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 anesthesia is the administration of medications in the office that induce either general anesthesia where the patient is totally asleep or sedation where the patient is in a semi-conscious state. All forms of IV sedation and General anesthesia are administered by a trained medical anesthesiologist 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 due to their nature require the use of general anesthesia or IV sedation, whereas others are best accomplished under local anesthesia. The choice of anesthesia 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 6 hours prior to surgery, taking all of your regular medications, bringing an escort with you and making arrangements for your recovery at home.
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 one¡¯s 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 important that you WILL NOT operate a vehicle or operate machinery for 24 hours after being sedation or general anesthesia.
Your doctor is also available to answer any specific questions you may have in regards to the anesthetic. The benefits of general anesthesia 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.
Coming to our office the day of surgery and anesthesia is no different than having surgery in the hospital and it is often much more user friendly. The equipment in our surgical suites and recovery room are similar to those used in the hospitals. When you arrive in the surgical suite the surgical assistant will connect you to a number of monitors and your doctor will start an IV. Safe anesthesia demands the use of several non-invasive 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 use Nitrous Oxide (laughing gas) to help you relax. The IV will be removed and you will be walked to a recovery bed where you will finish recovering. Once you are fully recovered the surgical assistant 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.