At Precision Oral and Maxillofacial Surgery, the overall patient experience is extremely important to Dr. Pierse and his staff. For all procedures, the practice can provide sedation in combination with local anesthesia, allowing patients to remain comfortable, pain-free and safe throughout their treatment.
The type of anesthesia that patients receive depends on the nature of their surgical needs, medical history and level of anxiety. Forms of anesthesia include local anesthesia, nitrous oxide with local anesthesia, IV sedation with local anesthesia and general anesthesia.
Dr. Pierse completed an intensive and comprehensive rotation in anesthesia as a requirement of his residency training and certification. After finishing residency, every Oral and Maxillofacial Surgeon must then undergo an office-based evaluation with state board examiners. Dr. Pierse performs a series of procedures on patients under moderate-deep sedation while being evaluated for overall patient care and safety. Furthermore, the examiners conduct an oral examination with the surgeon and staff, evaluating proficiency in emergency management. Only then will the state board allow the surgeon to practice sedation in an office-based setting.
Dr. Pierse has completed these requirements and maintains licensure to administer all forms of anesthesia in the state of Arizona. Below are the methods Dr. Pierse uses to promote patient comfort and safety.
Local anesthesia, such as lidocaine, temporarily reduces or eliminates sensation in the area of treatment. On their own, these medications do not affect the patient’s state of consciousness or help them sleep through the procedure. Dr. Pierse uses local anesthesia in every surgical procedure. He typically combines this with other anesthetic methods, though patients may receive local anesthesia alone for procedures such as minor soft tissue surgeries and simple tooth extractions.
Nitrous Oxide (Laughing Gas)
Nitrous oxide has been used for many years for its sedative and analgesic (pain-controlling) effects. It is safe and is eliminated from the patient’s system quickly after the procedure is finished. Inhalation sedation is safe and poses no risk of side effects to the heart and lungs. Patients will become relaxed quickly and benefit from its effects shortly after its administration, which is why it can also be used in conjunction with moderate-deep sedation for patients suffering from extreme anxiety or poor venous access. A nasal mask is used to administer the nitrous oxide in combination with oxygen at variable concentrations. The gas works rapidly, allowing the patient to become relaxed and comfortable immediately prior to and throughout the treatment process.
Dr. Pierse may use nitrous oxide in simple to more involved surgical procedures, such as removing wisdom teeth and placing dental implants. Patients are able to breathe on their own throughout the entire procedure and maintain control of their bodily functions. At the completion of the surgery, the nitrous oxide is turned off and the patient recovers on 100% oxygen, allowing the nitrous oxide to be removed rapidly. The patient may experience a mild amnesia without nausea once the procedure is completed.
Note that Dr. Pierse may advise against using nitrous oxide for patients that have certain medical conditions such as emphysema, COPD or multiple sclerosis.
Our practice offers the option of moderate-deep sedation, sometimes called “twilight” or conscious sedation. This technique allows the patient to be comfortable, relaxed and anxiety-free throughout the surgery.
This is accomplished by giving medications that decrease cardiac and respiratory function while still allowing patients to breathe on their own. The technique also provides a more profound state of amnesia, meaning that patients will not remember most of the experience.
Patients respond to IV sedation differently. They may not sleep through the entire surgery, but they will always be comfortable and pain-free. The procedure is conducted in a controlled environment and every patient is monitored closely throughout their treatment. For safety reasons, patients with medical conditions or those who take specific medications may only be lightly sedated.
IV medication is administered through a catheter placed in a vein in either the arm or hand. Common medications include Fentanyl, Ketamine, Versed and Propofol. Dr. Pierse will deliver the least amount of medication necessary to complete the procedure. When compared to oral sedation, IV sedation is far more predictable and managed more discretely.
When the patient’s extensive medical history or complexity of the procedure prohibits IV sedation, Dr. Pierse may elect to complete the surgery under general anesthesia in a hospital setting.
Again, when it comes to any procedure offered by Precision Oral and Maxillofacial Surgery, our highest priority is the patient’s safety and comfort. Dr. Pierse will review these anesthetic options thoroughly during your consultation and he will take the time to address any concerns that you may have on the day of your surgery. Please feel free to get in touch with our office to ask questions or to schedule an appointment.
Contact Precision Oral and Maxillofacial Surgery online or by phone at Phoenix Office Phone Number (623) 518-2325.