Oral and maxillofacial surgeons are unique among the surgical specialties with regards to anesthesia training. Every oral and maxillofacial surgeon during their residency receives formal anesthesia training with the Department of Anesthesia in the hospital. This includes I.V. sedation, airway management and intubation techniques. This also includes complete training in Advanced Cardiac Life Support. Most states have very strict guidelines regarding the administration of anesthesia in the office to ensure patient safety. Dr. Ettinger follows the guidelines and protocols set forth by our state medical and dental regulatory body and our office is regularly inspected.
Dr. Ettinger has advanced training in all aspects of anesthesia and emergency care. This commitment has provided our patients with the highest standards of care and availability of the latest techniques and drugs. It is our utmost goal to make your surgical experience as pleasant and stress free as possible while maintaining the highest levels of safety. Dr. Ettinger completed his anesthesia training at the Hospital of the University of Pennsylvania in the Department of Anesthesia.
Many patients can have their procedures completed using a local anesthetic to "numb" the area. For those people wishing to be sedated so that they are unaware of the surgery, I.V. sedation is offered.
During the initial consultation you and Dr. Ettinger will discuss the type of procedure involved, your medical history and your level of anxiety. Some procedures, due to their nature, require the use of I.V. sedation, whereas others are best accomplished under local anesthesia. The choice of anesthesia is always a personal decision and should be made only after an informative consultation with Dr. Ettinger. In addition, during the initial consultation, you will be given instructions to prepare for surgery such as; wearing loose, warm, and comfortable clothing, not having anything to eat after midnight and clear fluids (i.e. pop) up to 4 hours prior to surgery, taking all of your regular medications, bringing an escort with you and making arrangements for your recovery at home (preoperative instructions).
Although most of the more modern anesthetic medications are kind to the stomach and do not produce nausea, occasionally just the anxiety that one has about having surgery can generate a queasy feeling in one's stomach. A patient who becomes sick with a full stomach could present a potentially dangerous scenario of choking. Therefore, it is important to follow all preoperative instructions. The medications used for sedation do persist in the blood stream for up to 24 hours. Therefore it is understood that you WILL NOT operate a vehicle or operate machinery for 24 hours after being sedated.
Dr. Ettinger is also available to answer any specific questions you may have in regards to the anesthetic. The benefits of intravenous sedation include a decrease in anxiety and awareness during the surgery. This translates into near or total amnesia of the procedure, lack of noise perception and no pain. During the procedure it is important to note that patients are still given local anesthetic to "numb" the area as partially sedated patients may feel occasional pressure.
Coming to our office for the day of surgery is no different than having surgery in your own hospital and it is often much more user friendly. The equipment in our surgical suites and recovery room are the same as those used in the hospitals. When you arrive in the surgical suite, the nurse or dental assistant will connect you to a number of monitors. Safe anesthesia demands the use of several noninvasive monitors that we attach to you. These devices are typically a blood pressure cuff, an EKG (electrocardiogram) and a pulse oximeter (a device that measures the amount of oxygen in your blood). Therefore, it is suggested that you wear loose clothing to facilitate the application of these important devices. Routinely, drugs will be injected into the I.V. to cause you to relax or sleep. Once you are able to sit up, the I.V. will be removed and you are almost ready to leave. At this time the recovery room nurse will review with you and your ride all the postoperative instructions and answer any questions either of you may have in regards to care of your mouth. Dr. Ettinger is always on-call and he can also answer any emergency questions you may have in regards to your care following surgery.