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of Texas Areas

Anesthesia Instructions - General Information

Eating and drinking instructions - preoperatively

It is the anesthesiologist’s job to identify and eliminate all recognizable risks associated with anesthesia – this is what keeps the track record for safety in office-based anesthesia so great.  An important safety parameter for anesthesia provision is strictly following appropriate guidelines for eating and drinking. Although the guidelines for eating and drinking have become more patient friendly in recent years, failure to properly follow these guidelines can result in the cancellation of the procedure.  The current guidelines recommend the following:

Eating no solid food, semi-solid food or any type of dairy product should not be consumed less than six (6) hours prior to an appointment

Drinking clear liquids (water, juice, pedialyte, Gatorade, soda) can be consumed up to two (2) hours prior to the appointment

For Example, if you have an appointment at 11:00 AM, a light meal would have to be consumed before 5:00 AM and clear fluids could continue until 9:00 AM. If you have an appointment at 2:00 PM, a light meal would have to be consumed before 8:00 AM and clear fluids could continue until Noon.

Dressing for the appointment

You are encouraged to wear loose, comfortable clothing (pajamas for children are acceptable). With colder weather, layering is the best. The provision of anesthesia requires access of your arms and legs for monitors and the administration of medications. Wearing tight clothes (leggings/thermals under pants, tight jeans, extra shirts, and tight long sleeve shirts) make it more difficult to care for the patient. We do recommend that the patient bring an extra set of undergarments and clothes - accidents especially in children can happen!

Medications

It is recommended to take all medications as prescribed unless specifically advised. It is not typically necessary to stop taking any medications before an anesthesia procedure, especially medications routinely taken every morning. It is recommended to take morning medications with a very small amount of water. If medication must be taken with food, it is recommended to take the medication with a very small amount of applesauce. It is always important that you report all medications that you take, either prescribed or over the counter, to your dentist/anesthesiologist. Finally, be very accurate and clear about reporting all medical conditions and current medications in your health history questionnaire. There are certain conditions that could require alterations by the anesthesiologist in the dosing or timing of drug administration before your appointment. A few good examples are diabetes, asthma, or a past history of heart defects or surgeries.

Recent Changes in Health

Optimal health is very important to ensure the best possible anesthetic for an upcoming dental appointment. If a procedure is scheduled and the patient is sick or ill prior to, or on the date of the appointment, it is recommended to contact our office to discuss the situation and determine the best course of action. Depending on what symptoms the patient exhibits will determine whether the procedure should be rescheduled or not. Any high temperatures, respiratory congestion, runny nose, coughing or wheezing should be evaluated and assessed by reporting these changes to the dental office. None of these symptoms by themselves are usually enough to cancel the appointment, however multiple symptoms or any ongoing illnesses may dictate reappointment for the safety of the patient.

Escort

Absolutely no patient who receives sedation or anesthesia can operate a vehicle following discharge from the dental office. Additionally, patients will require at least one adult to provide observation and supervision for a period of three to four hours after leaving the dental office. Sometimes it can take longer for a patient to fully recover and it is advised to make arrangements to stay as long as necessary with the patient. It is our best recommendation for any patient to have a responsible adult stay with them until they are fully recovered. Adults should refrain from operating machinery, making decisions or purchases, or signing any contracts during the recovery period due to the effects on of anesthesia on judgment and memory until fully recovered.

We also recommend that two adults are with the child, especially for the ride home. This allows one adult to drive the car and not be distracted while the other adult sit next to the child to observe them and make sure they are safe in the car. We also suggest that no other children are brought to the appointment particularly younger children or infants who will require an adult to watch them because this can potentially result in the sedated child not being properly observed. It is important that all patients have appropriate safety restraints for the ride home. Children of appropriate age should be in car seats or booster seats or reclined in the vehicle safely as long as appropriate safety restraints are utilized and an adult not driving is riding with them. After arriving home, we appreciate a call to the dental office to let us know you made the journey safely.

Once home, children may quickly to recover back to their normal presentation, however the residual effects from the anesthesia can be deceiving and can last the rest of that day. Normal activities can be resumed the following day.

Drinking and Eating - Postoperatively

Our best recommendation is to wait until the patient if fully awake before giving them anything to drink. If a patient receives something before they are fully awake they risk vomiting or aspiration. If a patient vomits following drinking something too soon, it is our experience that it can take 20-24 hours for the vomiting to stop, even with medications. Always start with small amounts of clear fluids and slowly increase volumes to avoid any issues with nausea or vomiting. When clear fluids are able to be consumed without any problems, then slow progression to more solid food is allowed. This is also the time to administer medications (prescribed by the dentist, regular medications or other recommended medications). The rule for the recovery period following the anesthesia appointment is that liquids are more important than solids – therefore do not push the solids.

The adult patient can typically drink when they are ready. It may even be advised to drink something before leaving the dental office. But in children we strongly encourage parents to not attempt to give any fluids to their child before they are fully awake. Allowing fluids before leaving the dental office will almost certainly guarantee the child will get sick during the bumpy ride home. Please wait until you get home and are motionless before attempting to give your child any fluids.

Helpful Information About the Appointment

Providing you with useful information and making you a well-informed patient is just as important as providing you with comfortable and safe anesthesia. Never hesitate to ask questions, or share issues or concerns about the anesthesia that will be provided. It is always better to ask questions and address concerns before the procedure instead of the day of the procedure. Here is some more helpful information:

Adult Patients

It is advised to not consume any alcoholic beverages eight hours before and after the procedure. If you smoke, it is advised to discontinue smoking at least 2 days before the procedure. Realizing for many patients this may be difficult, any reduction in smoking before the procedure is beneficial. When you come to the treatment room, you will meet your anesthesiologist who will discuss with you your anesthesia plan designed for you. Ultimately, your comfort and positive experience is our goal, but your safety is our priority. If there is any concern regarding your ability to safely undergo anesthesia during the procedure, it will be discussed with you.
Once the medical history is reviewed and the anesthesia plan discussed, monitors including EKG (heart monitor), blood pressure, precordial stethoscope, pulse and oxygen saturation will be placed. Medications and fluid are given through a small IV that will also be placed by the experienced anesthesiologist. All patients are monitored continuously throughout the procedure by the anesthesiologist until all dental treatment is completed. At the completion of the dental treatment, the patient will continue to be monitored until the anesthesiologist determines that the patient is stable and able to go into recovery. During the recovery period, anesthesia instructions will be reviewed and any questions about the procedure will be answered. All patients are given written instructions which include contact information if there is any need to call after leaving the dental office.

Pediatric Patients

Do not have your child stay up late the night before the procedure. This can actually cause the patient to take longer to recover after the procedure. It is usually not helpful to wake your child early to give them something to eat or drink before the procedure. Changes in their regular schedule in any way do not help with the planned procedure.

The child will come to the treatment area with one or both parents. We encourage family to provide comfort and support, but due to space challenges we typically only allow up to two adult family members. We ask a parent/family member to sit with the child in their lap. After reviewing the medical history and a full explanation of the anesthesia plan, an injection is given that consists of fast-acting anesthesia sedatives. The child stays with the parent/family member until the desired effect of the medications is achieved, typically about 5 minutes. Once the child is relaxed and sedated, the child is taken to the actual treatment area where the dental and anesthesia equipment has been set up out of the patient’s view. Please understand that no parent, family member or other person will be able to stay with the child once the medications take effect. This is done for the safety and well-being of the child. If you have any concerns about staying with your child, please discuss this with our office. When the child arrives in the treatment area, monitors including EKG (heart monitor), blood pressure, precordial stethoscope, pulse and oxygen saturation will be placed. Medications and fluid are given through a small IV that will also be placed by the experienced anesthesiologist. All patients are monitored continuously throughout the procedure by the anesthesiologist until all dental treatment is completed. At the completion of the dental treatment, the patient will continue to be monitored until the anesthesiologist determines that the patient is stable and able to go into recovery. Every effort is made to have the monitors and IV removed, and reunited with the parents before the child is aware of his surroundings. It is not unusual for the child to be irritable and fussy in the immediate recovery period due to the disorientation from the medications, and also the mouth numbness from the local anesthesia administered while they are sleeping. Thankfully, a little tincture of time is all that is needed to finally calm the waking child.

During the recovery period, anesthesia instructions will be reviewed and any questions about the procedure will be answered. All patients are given written instructions which include contact information if there is any need to call after leaving the dental office.

After Hours Contact

If there is any question or concern, please contact the dental office or Anesthesia Alternatives first to assist in the evaluation and assessment of the patient. In the highly unusual event we cannot be reached and the patient is experiencing a serious problem (difficulty breathing, unresponsiveness) call 911.

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American Society of Dentist Anesthesiologists  •   Texas Society of Dentist Anesthesiologists