anesthesia

Should bilateral inferior alveolar and lingual nerve blocks be given for wisdom teeth surgery?

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An interesting article titled “Should we be giving bilateral inferior alveolar and lingual nerve blocks for third molar surgery,” appears in the British Journal of Oral and Maxillofacial Surgery and written by J. Jabbar and et al. (2014, vol. 52, pp. 16-17). The article discusses how when someone is having their wisdom teeth extracted they are usually given general anesthesia and 2 inferior alveolar nerve blocks or local anesthesia in one or two visits. The authors feel there is controversy over whether 2 inferior alveolar nerve blocks should be given to patients in a single visit. The authors say the most common complications thought to be associated with bilateral inferior alveolar nerve blocks are injury to the tongue during anesthesia, unpleasant effects, loss of control of the tongue, and bilateral anaesthesia of the tongue, which can lead to collection of fluid in the oral cavity and aspiration. The authors mention a few past … Read more

How safe is deep sedation or anesthesia in dentistry?

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An interesting article titled “How safe is deep sedation or general anesthesia while providing dental care?” appears in the Sept. 2015 issue of JADA (volume 146, issue 9, Pages 705–708) and written by Jeffrey D. Bennett and et al. The article discusses how deep sedation and general anesthesia are given daily in dental offices or practices and this is usually done by oral and maxillofacial surgeons and dentist anesthesiologists. Sedation and anesthesia is given to patients to be able to more easily perform procedures and keep the patient safe and comfortable. Unfortunately in rare cases problems can happen and hence the authors were interested in exploring this. The authors state “Using the available data and informational reports, the authors estimate that the incidence of death and brain injury associated with deep sedation or general anesthesia administered by all dentists most likely exceeds 1 … Read more

Pediatric Dental Death in Cambridge, Ontario, Canada Spurs Comments on Dental Anesthesia

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Recently, a death has occurred in Cambridge, Ontario, Canada, in a dental office. Details of the case have not yet been released, but a boy died after getting anesthetic and had a previously undetected heart condition. It seemed to have occurred sometime around late April, 2014, but the date may be off a bit. It appears that in this case the boy was brought to a hospital after the dental office in an attempt to save his life. An interesting article over in the Cambridge times published June 27, 2014, by Gordon Paul, titled “Pediatric dental surgery with anesthesia should be done in hospitals, dentist says,” provides some comments on this case. See http://www.cambridgetimes.ca/news-story/4605070-pediatric-dental-surgery-with-anesthesia-should-be-done-in-hospitals-dentist-says/. In this article comments by Dr. Hanover who is on the political action committee of the Ontario Dental Association are provided. He says “I think every pediatric dentist … Read more

Updates on Anesthesia Provided by Oral and Maxillofacial Surgeons

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Recently, it has come to my attention that the American Association of Oral and Maxillofacial Surgeons (AAOMS) has released a new white paper titled “Office-Based Anesthesia Provided by the Oral and Maxillofacial Surgeon,” in 2013, located over at http://www.aaoms.org/docs/papers/advocacy_office_based_anesthesia.pdf. This data contains some important data from the OMS National Insurance Company (OMSNIC) which to my knowledge had been previously closed. This data is Anesthesia Morbidity and Mortality Data from 2000 to 2010  for a total of 29,975,459 in-office anesthetics (conscious sedation, deep sedation and general anesthesia) provided by oral and maxillofacial surgeons in their offices. It was found from this data that the ratio of office fatalities/brain damage per anesthetics administered is 1 to 365,534.  I had long wondered what this data showed as I have previously looked at numerous studies attempting to determine how many deaths occur when anesthesia … Read more

Propofol-Remifentanil Versus Propofol-Ketamine for Third Molar Surgery

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A study titled “Comparison of Propofol-Remifentanil Versus Propofol-Ketamine Deep Sedation for Third Molar Surgery” appears in the 2012 Anesthesia Progress journal. The authors of the study set out to better determine what anesthetic to provide during third molar (aka wisdom teeth) surgery. In the study, two drug combinations for use as deep sedation during oral surgery were evaluated. Patients in a control group received a continuous intravenous infusion of propofol-remifentanil,  and patients in an experimental group received a continuous intravenous infusion of propofol-ketamine. This study was double blind in that neither patients nor surgeons were aware of which treatment was given. In this study, 37 patients  were monitored while sedated for respiratory, heart rate, and blood pressure stability. Emergence from the effects of anesthesia and total recovery time were recorded. In addition, patients and surgeons were both asked to rate … Read more