IN OFFICE GENERAL ANESTHESIA
Technique for General Anesthesia in the Dental Office
Depending on the type of dental procedure(s) being performed, your child will be receiving either an intravenous anesthetic or an anesthetic gas that allows him or her to have minimal or no awareness of the dental procedure, maximum comfort and the highest degree of safety. These anesthetic techniques provide excellent conditions for your dentist to perform the needed dental work in one visit that might otherwise require many dental visits to complete. As mentioned above, Capital Pediatric Dentistry has an anesthetic setup in the dental office, which is very similar to those present in any operating room. We have equipped our treatment and recovery rooms with state of the art monitoring equipment, suction equipment and a full array of A.C.L.S. (Advanced Cardiovascular Life Support) resuscitation equipment for emergencies. This emergency equipment includes all necessary medications, airway support equipment, and a defibrillator.
Our anesthesiologist will contact you directly before the scheduled dental procedure at the phone number(s) you have provided. The purpose of this call is to obtain a brief medical history, provide pre-procedure eating and drinking instructions, to discuss the details of the anesthetic management, and to answer any other questions you may have regarding the anesthetic technique.
At the time of your scheduled appointment, you will meet with both the anesthesiologist & Dr Crippen. You will have an opportunity to ask any questions or express any concerns you may have with the proposed treatment. Your child will then receive a pre-medication while still with you. The purpose of this "pre-med" is to ease the separation of you and your child once treatment is ready to begin. The pre-med is usually given in the form of a liquid to be taken orally. This oral pre-medication contains midazolam, an anti-anxiety drug from the same family as valium. The sedation effects of the pre-med are usually apparent in 15-20 minutes after administration. At that time, your child will be sleepy and/or very 'drunk'. He or she may not close their eyes at this point but they will have no recall of subsequent events of the visit. At this point, you will be asked to wait in the reception area while we begin the case.
Your child will then be administered either nitrous oxide or an anesthetic gas through a mask to place him or her into a deeper level of sedation. Once your child is "asleep", the doctor will painlessly start an intravenous catheter in order to keep your child well hydrated and to administer additional anesthetics and pain medications throughout the procedure to keep your child comfortable. We will also attach the necessary monitoring equipment to your child. Our doctors will remain in immediate attendance of your child throughout the dental treatment monitoring vital signs and continuing to administer the appropriate anesthetic medications on an as needed basis. Our anesthetic technique will not only include sedatives but pain medication as well.
At the end of the procedure, Dr Crippen will come to you in the reception area and explain how the treatment has proceeded. Our anesthesiologist will remain with your child until he or she is opening their eyes. Emergence from this type of sedation is gradual and your child will likely need 20-30 minutes after the completion of the dental treatment to wake up. You can join your child as soon as they open their eyes. One possible side effect of the sedation is mild shivering but this will resolve quickly. Another possible side effect is disorientation. This disorientation or "emergence delirium" is transitory & will likely resolve within 15min.
You may find that your child is grumpy, fussy, or not completely themselves for a few hours after the sedation. In fact, it will take at least 4 hours (or so) after you return home until your child is completely over the effects of the anesthetics. The emergence from this type of anesthesia is very gradual. Your child may complain of dizziness, and not being able to focus very clearly for the first 2 hours after you return home. These are normal side effects of the anesthesia and will gradually wear off. There are no long-term side effects of the anesthetic medications used for general anesthesia.
You will receive detailed instructions about what to expect after the procedure both from Dr Crippen and from our anesthesiologist. Please read the instructions provided for you below to give you an idea of what to do before the treatment and what to expect afterwards.