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Anesthesia and Sedation

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Anesthetics and Sedation

• Reduce pain

• Relieve anxiety

• Different levels of sedation can be achieved based upon procedural need and patient response

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Conscious Sedation

• Causes an altered state of consciousness

• Patient can still communicate

• May experience headache, nausea, brief periods of amnesia

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IV Sedation

• Administered directly into the bloodstream

• Patient may be conscious but in a deeply relaxed state

• Patient has no memory of events taking place while sedated

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Oral Sedation

• Prescription taken before appointment

• May make the patient calm and drowsy or calm and relaxed

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Inhalation Sedation

• Odorless and colorless gases

• Inhaled through mask

• Patient doesn’t remember much of procedure

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Intramuscular Sedation

• Injection into muscle of upper arm or thigh

• Not commonly used

• Takes 20 to 30 minutes to take effect

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General Anesthesia

• Creates an unconscious state

• Must be carefully controlled

• Sensation and feeling is lost

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Topical Anesthesia

• Numbs a particular area

• Used prior to local anesthetic

• Desensitizes the oral mucosa

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Local Anesthesia

• Produces a deadened or pain free area

• Sensory impulses are temporarily blocked

• Affects the nerve fibers carrying messages to brain

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Topical Anesthetics

• Used for the following:– Subgingival scaling– Root planing– Seating crowns– Placing matrix bands– Periodontal probing– Preparation for local sedation – Repress gag reflex

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Placing Topical Anesthetic

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Local Anesthetics

• Used to manage pain

• Can be short, intermediate, or long in duration

• Vasoconstrictor

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Possible Complications of Local Anesthetics

• Toxic reactions– Patient becomes ill– Many factors

• Paresthesia– Numbness does not go away as expected

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Types of Injections

• Local infiltration– Injection near small terminal nerve

branches

• Field block– Injection near large terminal nerve

branches

• Nerve block– Injection near main trunk nerve

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Maxillary Arch Injection Sites

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Anesthetic Setup

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Aspirating Syringe

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Components of a Needle

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Needle Care and Handling

• Maximum of four penetrations• Stick protection• Caps and shields• Proper disposal• OSHA guidelines• Sharps container• Procedure if stick occurs• OSHA Bloodborne Pathogens protocol

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Anesthetic Cartridge Components

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Retracting Harpoon

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Loading Cartridge into Syringe

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Engaging Harpoon

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Placement of Needle into Syringe

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Passing the Syringe

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Disassembling the Syringe

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Intraosseous Anesthesia

• Cancellous bone injected directly• Special equipment required• Anesthetizes the following:

– Bone– Soft tissue– Root– Teeth– Single or multiple teeth

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Periodontal Ligament Injection

• Used for pulpal anesthesia of one or two teeth in a quadrant

• May be an adjunct to another injection where patient is partially anesthetized

• Aids in diagnosing abscessed teeth

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Periodontal Ligament Injection System

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Intrapulpal Injection• Delivered directly into nerve chamber

• Procedures– Root canal therapy – Severe abscess

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Electronic Anesthesia

• Used with nitrous oxide provides a better effect

• Used in the following procedures:– Placing restorations– Muscle relaxation– Determination of centric occlusion

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Computer-Controlled Local Anesthesia Delivery System

• Pain-free injections

• Used for all traditional infiltration and block injections

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Nitrous Oxide• Safe, stable, non-flammable gas

• Relaxes and comforts the patient

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Nitrous Oxide• Contradictions

– Blocked nasal passage– Emotional instability

• Drug users

– First trimester of pregnancy– Risk of bone marrow suppression– In-vitro fertilization procedures– Neurological complaints