Anesthesia of Dental Patient

Lecture 14

What patient details do you need to know prior to anesthseia to ensure you make the right plan and decisions?

history

physical exam

diagnostics

What procedure details do you need to know prior to anesthseia to ensure you make the right plan and decisions?

duration

location

variation

List common canine conditions/comorbidities found in the dental patient.

heart disease

hyperadrenocorticism

diabetes mellitus

osteoarthritis

obesity

List common feline conditions/comorbidities found in the dental patient.

kidney disease

hyperthyroidism

GI / Pancreas

Obesity

Musculoskeletal

What events may complicate your life during a dental procedure?

positioning and moving of patient

wet / cold conditions

changing pain level for patient

access to mouth may affect monitoring capabilities

What creates mild to moderate stimulation during patient experience of a dental?

imaging —> dental radiographs, CT

cleaning —> hand and/or ultrasonic scaling, polishing

gingival exam / probing

What creates moderate to high stimulation during patient experience of a dental?

extractions

fracture management / tumors

implants

How do you manage stimulation under anesthesia for a dental?

drugs (before, during, after)

monitoring

preparation of area / equipment

regular check of patient positioning / padding

capnography

Describe a dental anesthetic plan for cats.

Pre-hospital: Gabapentin

Pre-med at hospital: Opioid/Sedative

Induction agent: Propofol/Alfaxolone

Dental Local Anesthesia/Blocks

NSAID (if needed)

What is the 5 P’s?

Hint: it’s a saying, not a list

Prior Preparation Prevents Poor Performance

What knowledge can help you achieve the 5 P’s (Prior Preparation Prevents Poor Performance)?

knowledge of comorbidities

additional diagnostics if indicated

stabilization before procedure

specific monitoring needs and interpretation

identify needs for additional drugs during procedure —> blood pressure support, MAC reducing drugs, support drugs for comorbidities

What complications are associated with anesthesia for dental procedures?

tracheal lacerations

aspiration

corneal ulcers

CV compromise

pain

hypothermia

vision loss

In regards to dental procedure complications, what should you keep in mind for determining the cause and management of said complication?

how and why it happened

recognition that it happened

how to treat it

risk limitations it creates

What should you think about post dental procedure?

will there be pain and how will it be managed?

did you cause lingual trauma? will the patient potentially cause lingual trauma to itself because the tongue feels funny (RARE)?