General Anesthesia and Sedation
What is sedation?
Some sedative (similar to diyazem), narcotic anemone (morphine-like) and sometimes a combination of hypnotic medication is relieved and the patient is provided with a short amnesia (forgetfaness) and local anesthesia and the patient’s dental treatment can be done in a short time. This is not a general anesthetic, it is applied in the dentist’s office, not in the hospital or in the O.R. The patient can fulfill the commands he received from the physician. It is possible to have dialogue between the patient and the physician when the dentist says to open his mouth, the patient does it easily. During the procedure, the anesthesiologist monitors the patient and follows the pulse and blood pressure.
The patient, the effect of drugs after the operation of the mouth, the tooth process, pain, dislikes sounds, etc. He won’t remember, he’s not exposed to psychological trauma. This will facilitate the arrival of the patient to dental treatment in later sessions. Conscious sedation is highly safe in both adults and children. There are no known side effects. It is administered intravenous in adults. Dosage adjustment is made by weight. In children, oral (syrup), rectal (rectum), intranasal (nose) are applied to the shapes. Additional doses may be given according to the duration of the dental treatment process. It is possible to perform many dental treatments in one session (such as shots, fillings) and general anesthesia known as narcissists in folk language is provided with a combination of the main 3 groups of drugs.
What is general anesthesia?
- The patient’s temporary unconscious loss with the help of hypnotic drugs,
- Narcotic Analysitics (morphine-like painkillers) to undergo a painless operation, even if the patient is unconscious,
- Muscle relaxants (curds) and all the muscles in the body are relaxed and a comfortable surgical environment is provided. With the use of muscle relaxants, all muscles are temporarily paralyzed, including respiratory muscles that allow breathing, and a small tube that is sterile, which we call the endotracheal tube, is placed in the trachea of the patient’s breathing tube and the patient’s respiratory anesthesia In the control of the specialist anesthesia device (respiratory device) is provided.
The continuation of the general anesthesia is provided by a mixture of oxygen/air or oxygen/nitrogen protoxide, as well as gases such as volatile agents (sevorane etc.).
Complications of Anesthesia
With recent developments in medicine, the side effects of drugs used in anesthesia are very small and are rapidly excreted from the body. In addition, the current medical technology and the patient monitoring of both anesthesia devices and patients ‘ vital findings can be followed very closely. For these reasons, complications related to anesthesia (general or sedation) are very rare, as long as they are carried out in competent hands and in favorable conditions. The most feared of all anesthesiologists; Is the patient’s toughness. Because in the case of full anesthesia, if the patient has vomiting and this vomit passes to the patients ‘ lungs, it may cause lung pneumonia (pneumonia) which can be extremely severe and fatal. For this reason, we want our patients to be hungry for at least 8 hours (like fasting). The first rule of minimizing complications depends on the patient’s pre-op anesthesia examination in a detailed manner.
Pre-op Anesthesia Examination
Patients arriving in the hospital before the dental treatments, after the planned sections of the PreOp anesthesia examinations are performed. In the anesthesia examination, a physical examination of the patient’s detailed self-history (the surgeries or diseases that he had previously undergone, the medications he used repeatedly, etc.) is carried out. After the necessary examinations are performed, the surgery appointment is given.
Risk Groups for Anesthesia
- ASA-ı (patients with no health problems and minimum risk of anesthesia.)
- ASA-II (a group of patients with mild discomfort, such as diabetes and hypertension, but whose life does not affect its function.)
- ASA-III (a group of patients affected by life functions such as heart failure, respiratory insufficiency and high risk of anesthesia),
- ASA-IV (patient group with advanced heart, liver, kidney and respiratory failure)
The patient groups that we apply general anesthesia
We can examine ASA-ı and ASA-II children and adult patients in 5 groups.
- Children under 4 years of age-this group is very difficult to treat teeth with the way children are convinced.
- Children or adults with developmental feedback
- Adult patients with a high degree of phobia (fear)
- Surgical interventions requiring general anesthesia (bone graft, bone cyst, etc.)
- A group of patients who want to be performed under general anesthesia in a short time (2 – 3 hours) of many surgical procedures that are not possible in one session with local anesthesia