Anesthesia and sedation
The significant advancement in oral surgery and implantology techniques has been accompanied by the introduction of anaesthetic and sedation practices that allows a potentially unpleasant surgical procedure to be modified into a comfortable experience.
Sedation-analgesia techniques for oral surgery are a set of resources performed by an anaesthesiologist that consist of a combination of mild sedation, anxiolysis and amnesia to reduce the tension and anxiety that some dental procedures can produce in patients. There are many surgeries that can benefit from this anaesthetic technique, such as implant surgery, periodontal surgery, among others.
Conscious sedation is able to comfortably adjust adequate amnesia and analgesia together with a level of consciousness that allows simple commands (open the mouth, turn the head...) without affecting the patient's well-being and safety at any time. In addition, the patient's cooperation during the procedure provides the necessary conditions for the dentist to perform his or her task faster and more quickly.
In principle, the anaesthesiologist, during the preoperative visit, assesses the patient's medical history and any intercurrent pathology (hypertension, diabetes, heart disease) and the usual medication he/she may be taking. During the course of the procedure, he/she will explain how the sedation will be carried out, assessing each person's needs in a particular way. Your informed consent for the sedation is agreed and signed. Afterwards, you will be informed of the fasting rules to be followed according to the timetable of the surgery, as well as the pre-medication that you will be advised to take. The presence of the anaesthesiologist during surgery monitors vital signs (blood pressure, heart rate and oxygen saturation), adjusts the patient's sedation and provides the necessary setting for the dentist to work comfortably while the patient feels at ease. This monitoring allows the depth of sedation to be adjusted throughout the procedure.
At the end of the surgery, the patient will be able to go home accompanied and pain-free. Analgesics, antibiotics and anti-inflammatory drugs will be prescribed along with dietary guidelines to make the postoperative period easier and painless.
Local anaesthesia was introduced in dental practices more than 100 years ago. Nowadays, the options for anaesthesia are very varied in order to ensure the safety and comfort of the patient. Local anaesthesia is administered using a cartridge, a syringe and a single-use needle. It is essential to be aware of the wide variety of anaesthetics, the techniques that exist to administer them and the emergency situations or possible reactions that may result from their administration.
Topical anaesthesia is used to reduce the discomfort that may be caused by the injection. It acts by numbing the surface of the mucous membrane or soft tissue without having any effect on teeth or bone structures.
The aim of local anaesthesia is to reduce the patient's pain and anxiety for the duration of the treatment. The onset of the anaesthetic effect can be affected by different factors. The most significant is the pH. Along with the anaesthetic drug, other products are injected to enhance the anaesthetic effect. For example, in many cases, it is combined with a vasoconstrictor that will cause the vessels to contract, thus retaining the anaesthesia for a longer period of time and extending the duration of its effect. Another of these elements is sodium chloride, which helps the anaesthetic to enter the interior of the blood vessels.
There are two main types of injections. In one case an entire area of the mouth is numbed, for example one side of the jaw, and in the other small, localised areas are numbed.
In many cases, the pain felt when administering the anaesthetic is not caused by the needle injecting the anaesthetic but by the pressure of the liquid penetrating the tissue.
Sedation is the administration of medication to calm the patient during dental treatment. There are different levels of sedation. Sedation can range from having the patient awake but relaxed to having the patient completely unconscious (general anaesthesia).
There are different types of sedation depending on the level of sedation to be applied. Firstly, for minimal sedation, nitrous oxide inhaled through a mask is used. For a higher degree of sedation, the drug is administered intravenously.
Regardless of the type of sedation used, local anaesthesia is also used to numb the area to be treated and eliminate any discomfort or pain.