Conscious sedation in maxillofacial surgery

In any surgical specialty it is the case that, in order to solve the different problems that bring you to our offices, a surgical procedure, that is to say, a surgical intervention or operation, has to be performed as a last resort. This may be of greater or lesser extent, depending on the health problem that we have in front of us. And as you might expect, this intervention is painless and therefore requires the use of anesthesia.

Our experience, just the opposite of yours, when observing your faces when different surgeries are proposed to solve your problems, is usually one of fear. In many occasions it is more motivated by fear of anesthesia, or by fear of pain and those unpleasant sensations that surround the operation, than by the intervention itself or the risks that it may entail.

If we look for information about the history of anesthesia, although we find data much earlier than that date, it was not until the 19th century that a painless dental extraction was performed. It was with an inhaled anesthetic called nitrous oxide. From then on, as in all areas of medicine, the evolution in this field has allowed us, together with our procedures, to reach a total understanding. A kind of “marriage” in the operating room between the anesthesiologist and the doctors, so that we achieve a state of well-being, tranquility, serenity with absence of anxiety and nervousness for everything that surrounds the operation, mainly “pain”.

Which procedures require the most anesthesia?

The procedures that we most frequently indicate in the office are mainly oral surgery, that is, surgery in the mouth. These are mainly for the extraction of wisdom teeth, cysts, placement of dental implants. We also usually indicate in the treatment of temporomandibular joint pathology, after arthroscopy, arthrocentesis, or joint lavage.

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What type of anesthesia is required?

The anesthesia with which we perform these procedures is local anesthesia or local anesthesia and sedation. This last type of anesthesia is the one I want to talk about.

How does conscious sedation work?

It is an anesthesia in which we administer a local anesthetic in the area through a series of infiltrations to block pain as soon as possible. The anesthesiologist doctor administers intravenously the medication with which he achieves that conscious sedation, so pleasant and required more often by you at the end of the intervention.

This sedation produces a kind of “drunkenness”, which eliminates or diffuses the unpleasant sensation of being in an operating room; it also eliminates the sensation of pain or discomfort that can be produced by the infiltrations of local anesthetic. With this we also achieve greater comfort and safety in our work, because obviously, we work better if you are comfortable. We always try to do all this without you losing consciousness, which is a factor that scares you. We only achieve a state of relaxation, which makes the success of the surgery possible in a more efficient way.

A habit I have is to ask you, in the first review after the operation, about the experience of local anesthesia and sedation with which the operation was performed. Your answer is almost always the same, and that is that you would go through it again if necessary, without the slightest thought, and that you would recommend it with your eyes closed.

Undoubtedly, this type of anesthesia has made possible that the recovery is much shorter, because the postoperative period is lighter with this anesthesia than with general anesthesia and allows us to perform surgeries of an intermediate size, which before we could only perform with general anesthesia.

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Finally, we would like to tell you that at Policlinica Gipuzkoa we have the best anesthesiologists and operating rooms equipped with technology and resources that will ensure that you will find yourselves in an environment of maximum safety at all times.