Several methods of anesthesia are available. The method of anesthesia that is chosen for or by a patient depends upon the nature of the surgical procedure and the patient’s level of apprehension.
The following table illustrates the choices of anesthesia, a description of the anesthetic technique, and the usual indications for that technique.
MethodTypes of AnesthesiaDescription of TechniqueUsual Indications
Method Local AnestheticDescription of Technique The patient remains totally conscious throughout the procedure. A local anesthetic (e.g. lidocaine) is administered in the area where the surgery is to be performed. Local anesthetic is used in conjunction with the other methods of anesthesia in all oral surgery procedures.Usual Indications Simple oral surgery procedures such as minor soft tissue procedures and simple tooth extractions.
“Twilight” IV sedation and Local AnestheticAnesthetic medications are gradually titrated through an IV catheter to produce a state where you are totally relaxed and partially asleep. Local anesthesia is then given after you are sedated. Fasting for 8 hours is required.Ideal for anxious patients who want to be comfortable and calm with no recall of the procedure and a short recovery. Appropriate for most oral surgery procedures.
Method Office Based General Anesthesia with Local Anesthetic*Anesthetic medications are gradually titrated through an IV catheter to produce a state where you are completely asleep. Local anesthesia is then given after you are asleep. Fasting for 8 hours is required.Profoundly anxious patients who do not wish to be aware of any part of their procedure or patients having more invasive procedures such as impacted wisdom teeth removal or management of an acute abscess.
Method Hospital or Surgery Center Based General AnesthesiaDescription of Technique A patient is admitted to a hospital or outpatient surgery center where anesthesia is administered by an anesthesiologist.Usual Indications Indicated for patients undergoing extensive procedures such as face and jaw reconstruction and TMJ surgery. Also indicated for patients with medical conditions such as heart disease or lung disease who require general anesthesia.
Safe Administration of Anesthesia Outside of a Hospital
Administration of any form of anesthesia in any setting is a very serious and deliberate process. As board certified oral and maxillofacial surgeons, Drs. Domingo and Hartman have undergone extensive anesthesia training during their four year hospital based residency. Additionally the staff who assists the doctors during cases where anesthesia is provided are trained and certified to do so. The State of Rhode Island has verified the doctors training and credentials as well as performed a facility and provider inspections. Perhaps most importantly is the many years of experience and more than ten thousand safe and successful office based oral surgery procedures done with our anesthesia team model. Having performed thousands of procedures under office based general anesthesia, we have notable expertise in this area of practice. Rigorous continuing education, office drills, state of the art equipment and above all a sincere passion for what we do allow us to maintain that expertise. Careful physical examination, medical history review and the nature of the procedure being completed guide decisions on if office based anesthesia is appropriate and at what level of anesthesia.
Again, when it comes to anesthesia, our first priority is the patient’s comfort and safety. If you have any concerns regarding the type of anesthesia that will be administered during your oral surgery procedure, please do not hesitate to discuss your concerns with your doctor at the time of your consultation.