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.
MethodDescription of TechniqueUsual Indications
Local AnestheticThe 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.Simple oral surgery procedures such as minor soft tissue procedures and simple tooth extractions.
Office Based Conscious IV Sedation with Local AnestheticMedications are administered through an intravenous line (I.V.). The patient is breathing but completely comfortable. This type of sedation is very safe. Medications most commonly used are Fentanyl (opiate) and Versed (benzodiazepine). Supplemental oxygen is delivered through a nasal breathing apparatus and the patient’s vital signs are closely monitored.Simple oral surgery procedures to more involved procedures such as removal of wisdom teeth and placement of dental implants.
Intravenous Conscious Sedation (“Twilight Sedation”)
Our office offers our patients the option of Intravenous Sedation or Dental Intravenous Anesthesia or to some it is referred to as “Twilight Sedation” for their dental treatment. Intravenous Sedation or “twilight sleep” helps you to be comfortable and calm when undergoing dental procedures. Your treatment can be completed under intravenous sedation. Intravenous sedation or “IV sedation” (twilight sedation) is designed to better enable you to undergo your dental procedures while you are very relaxed; it will enable you to tolerate as well as not remember those procedures that may be very uncomfortable for you. IV sedation will essentially help alleviate the anxiety associated with your treatment. You may not always be asleep but you will be comfortable, calm and relaxed, drifting in and out of sleep – a “twilight sleep”.
If you choose the option of intravenous sedation your IV sedation/anesthesia is administered and monitored by the doctor therefore eliminating the costly expense of having your treatment carried out in an operating room or same day surgical facility.
How is the IV sedation administered?
A catheter will be introduced into a vein in your arm or hand. The catheter will be attached to an intravenous tube through which medication will be given to help you relax and feel comfortable. At times a patient’s vein may not be maintainable, in these situations the medications will be administered and the catheter retrieved – both scenarios will achieve the same desired level of conscious sedation. Once again some patients may be asleep while others will slip in and out of sleep. Some patients with medical conditions and/or on specific drug regimens may only be lightly sedated and may not sleep at all. Durig this type of sedation we are also able to adminiter antibiotics, steriods, pain medications and other medications to make the sedation and recovery process easier on the patient.
The goal of IV sedation is to use as little medication as possible to get the treatment completed. It is very safe, much safer than oral sedation. With IV sedation a constant “drip” is maintained via the intravenous tube. At any time an antidote can be administered to reverse the effects of the medications if necessary. Along with IV sedation there are also other different “levels” of sedation available to you in our office.