Anesthesia Options

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. 

Local Anesthetic

Local anesthesia is always provided. When you choose to only have local anesthetic, you will be totally conscious and aware throughout the procedure. This is the same as having an injection by your dentist for a filling, crown, or root canal. The numbing injection itself can be uncomfortable, but the injected medicine eliminates the sensation of sharp/stabbing/cutting pain and can last 4-6 hours. The numbing injection does not eliminate the sensation of pressure and vibration. Some patients find the pressure and vibration from some oral surgical procedures to be uncomfortable. Infections around the surgical site can occasionally decrease the effectiveness of the numbing medication. Many patients tolerate many oral surgical procedures under local anesthesia but some consider the experience to be uncomfortable. Local anesthesia is considered quite safe.

Nitrous Oxide (Laughing Gas)

Nitrous oxide is a colorless, slightly sweet gas that is used for relaxation and anxiety relief. When inhaled, it can induce feelings of euphoria and sedation. It also can produce sensations of drowsiness, warmth, and tingling in the hands, feet and/or about the mouth. It will not induce unconsciousness, and you will be fully aware of what is happening, though you will likely have less concern. You will be able to swallow, talk, and cough as needed. Local anesthesia (injection) is given after the nitrous oxide has become effective. 

Not all patients are appropriate for N2O. If you have vitamin B12 deficiency, congestive heart failure, chronic obtrusive pulmonary disease (COPD), chronic bronchitis, emphysema, chronic asthma, bronchiectasis, pregnancy, hepatitis B or C, tuberculosis, macrocytic anemia, immune diseases, respiratory diseases, middle ear infections, or a history of substance abuse, N2O may not be appropriate for you. 

N2O is considered quite safe in healthy individuals. Nevertheless, N2O carries some risk. You may feel nauseated, dizzy, drowsy, or claustrophobic during and after sedation. The feelings may be unpleasant to you and cause distress. In addition, for those who have anxiety and don’t like the feeling of not being “in control”, the N2O may increase their anxiety.

Office Based IV Anesthesia

We provide moderate/deep IV sedation in our office to facilitate the most comfortable surgical experience. This is not the same as being “put to sleep” like the general anesthesia that is provided in an operating room setting where a tube is placed down your throat (intubation) and connected to a machine to breath for you throughout the procedure. Nevertheless, most patients fall asleep during moderate/deep sedation but can respond to commands or questions when asked. Some patients go in and out of consciousness but are most often not in distress or anxious during periods when they are awake. The medications provided during moderate/deep sedation also cause amnesia, where patients rarely remember being awake during the procedure. Patients who regularly take certain medications such as anti- anxiety medications or use recreational drugs such as marijuana often experience a lighter level of sedation than those who don’t. The anesthesia will involve starting an IV in your hand or arm. Local anesthesia is provided along with the IV sedation.

This type of anesthesia is quite safe in healthy individuals, but not all patients are appropriate for moderate/deep IV sedation in the office setting. If you have poorly controlled hypertension, heart problems, liver problems, kidney problems, seizures, sleep apnea, asthma, diabetes, on blood thinners, or have a bleeding disorder, you will likely need a medical consult completed by your treating physician prior to your procedure. Please inquire with your surgical team to determine if you need a medical consult.

Hospital or Surgery Center Based General Anesthesia

Our practice maintain privileges at the hospital and the surgery center for those undergoing a procedure better suited for the hospital or surgery center, or those with significant medical conditions that are more appropriate to be treated at a hospital or surgery center. At these locations, general anesthesia is administered by a separate anesthesia provider who will ensure the patient is completely asleep for the procedure.