Today, general anesthesia is rarely used to treat teeth. One reason for this is that the intravenous sedation with midazolam use is effective for almost all patients and is very safe. The use of general anesthesia are much more risky.
Typically, general anesthesia for the treatment of adult patients should only be used in extreme cases when there are no other ways to cope with pain and anxiety
Anxiety - how to distinguish normal from disease?
. If the decision on the use of general anesthesia, it must take place in conditions of maximum safety. This means that this type of anesthesia used only in hospitals or special clinics, where there is all the necessary equipment. This policy led to the fact that general anesthesia was used less frequently; it is increasingly replacing intravenous conscious sedation.
The so-called deep sedation in some countries, also belongs to the category of general anesthesia. For example, propofol - one of the drugs for deep sedation. Most dentists have never used a pain relief as when deep sedation acceptable, they are generally preferred general anesthesia.
Disadvantages of general anesthesia in dentistry
Besides the risk of serious complications (which, although very small, is still much higher than with intravenous conscious sedation), general anesthesia has the following disadvantages:
- General anesthesia suppresses the cardiovascular and respiratory systems. For certain groups of patients, it is contraindicated or at least is allowed only in case of emergency (dental surgery such cases, as a rule, does not apply);
- General anesthesia is not recommended for use in performing routine dental procedures such as, for example, sealing. The potential risk is too great to justify the use of general anesthesia;
- Due to the significant risk to the use of general anesthesia, patients often need to undergo a medical examination, which includes laboratory tests, chest X-ray, electrocardiogram;
- For the operation with a general anesthetic is required by personnel with the necessary training, special equipment and a place that satisfies the applicable standards. In addition, it raises considerable difficulties for conducting surgery dentist - snorkel and temporarily paralyzed muscles of the patient are greatly interfere with his work and cause fatigue more quickly than usual.
- The patient can not eat or drink six hours before the procedure (otherwise possible vomiting, and it is very dangerous when using general anesthesia);
- The use of general anesthesia is expensive, increasing the already considerable cost of dental services;
- General anesthesia does not help to cope with the anxiety that plagues many patients before dental procedures. Fears directly related to anesthesia, may even enhance this anxiety.
When used
In some cases, the use of general anesthesia is acceptable and even recommended.
Intravenous conscious sedation works in about 97% of people experiencing extreme anxiety in connection with the operation. However, there is always a small percentage of people for whom such sedation is ineffective - because they are not able to adequately cooperate with the medical staff, even under the influence of sedatives and / or because of the high tolerance to the drug used. In this case, the best choice may be a general anesthetic.
When a potentially traumatic procedures also frequently used general anesthesia. In some clinics, patients who are especially afraid of any part of the treatment procedures, such as tooth extraction, it is proposed to carry out this step under general anesthesia, and, for example, has put a seal with sedation. However, it should be borne in mind that in this case you can not do the procedure is expensive.
As used general anesthesia
In most cases, the drug for general anesthesia is administered through a vein in the arm. If you use inhaled anesthetics to the face of the patient to wear a mask. In the first case, the patient typically stores the injection itself, and several seconds later, in the second case, generally only remember the moment when the tray to the face mask.
If the operation is expected pain during surgery, the patient is administered a long-acting local anesthetic. When the patient wakes up, he is in a few hours will not feel the pain, and then you can begin taking painkillers. It is much better to prevent the emergence of pain than to take action against them when they have already appeared.
One of the most common fears of patients with respect to general anesthesia is associated with the fear of not wake up. First, you must understand that general anesthesia be appointed only if the doctor understands - without the operation for the patient will be too unpleasant. Provided that you work with a qualified anesthetist, the risk of death from anesthesia extremely small. According to a study from 1982, from complications of general anesthesia, the patient died 1 of 338,536. And that was 30 years ago - now medicine as a whole has become even safer.
Intravenous and inhalation anesthesia
Separate the two main categories of anesthesia - intravenous and inhalation. In most cases the gas used to maintain anesthesia after administration of intravenous anesthetic.
Previously, the use of inhalation anesthesia was pretty uncomfortable for the patient because of the unpleasant odor. Today, it uses drug sevoflurane, who does not have a strong odor (smell it a little bit reminiscent of wet fur), and acts very quickly.
Anesthesiologists sure to use intravenous anesthesia for general anesthesia in adult patients (in combination with an inhaled anesthetic, or not), many also prefer to use it for the kids. If the patient is afraid of injections, it may enter into a state of anesthesia using inhaled medications, but then commonly used intravenous anesthetics.
