As an oral and maxillofacial surgery practice we are fully trained to offer patients general anesthesia for their surgical procedure in our outpatient office. People often have misconceptions about the kinds of anesthesia that is offered due to the many terms and phrases used to describe outpatient anesthesia procedures. People often use the term “twilight” or “sedated” to describe their expectations or fears. To help clarify what will happen during the surgery I will attempt to give easy to understand definitions.
General anesthesia as defined by the American Society of Anesthesiologists is defined as the level of sedation where a painful stimulus will not elicit a response. In common terms that would mean that the patient will not be able to verbally communicate during the procedure. Many times the misconception is that general anesthesia is not being performed without a breathing tube being inserted. Hospital based general anesthesia often uses this technique due to the longer time of anesthesia and the patient being flat on the operating table. General anesthesia in its true definition does not require a breathing tube. Due to the shorter duration of our procedures we can safely perform this level of anesthesia on healthy patients in our outpatient clinic.
IV sedation or “twilight” anesthesia allows the patient to have a sedative such as valium or other similar medication to ease the anxiety of the procedure. Although the patient may not have a clear memory of the procedure they are awake enough to respond to questions and follow directions during the procedure. This is helpful in some procedures but does often have the patient remember or experience some of what is happening during their procedure. This level of anesthesia also varies in the surgeon or provider’s administration of medications. Some providers will prescribe a sedative medication to be taken prior to coming to the office while others will give these medications through an IV.
Finally, nitrous oxide analgesia or “laughing gas” is an even lighter form of sedation designed to ease the anxiety of the procedure. Patients typically have full memory of the procedure but find it easier to undergo the treatment with the help of the gas. This is inhaled through a mask placed over the nose and can be adjusted to some degree to the patient’s tolerance level. It should be noted that nitrous oxide does not allow us to avoid the administration of local anesthesia. Patients under the “laughing gas” will continue to feel the pressure and manipulation being done throughout the treatment.
All forms of anesthesia are subject to a review of the patient’s medical history. It is sometimes impossible for us to provide the level of anesthesia requested due to significant medical problems. Also, some procedures that require more time or appear to be more difficult are scheduled at the hospital for safety reasons. It is important to discuss these issues or any questions you may have about anesthesia with our staff at the time of your consultation appointment. At Pottstown Oral and Maxillofacial Surgery our doctors are fully trained in the administration of anesthesia and the management of complications, advanced life support techniques for adults and children and CPR. At our office we employ a wide range of skilled assistants, including registered nurses, who in conjunction with our doctors will manage our patients during the entirety of their stay.