Anaesthesia in the dental chair

Abstract

General anaesthesia is used mainly for extractions and for conserve, ion in specific groups of patients. The use of general anaesthesia in dental practice has declined steadily over the past 25 years 1 (Figure). However, the number of patients who receive treatment in the general anaesthesia departments of Dental Schools has increased over the past 5 years. This may indicate the beginning of a trend in dental anaesthesia as new recommendations on equipment and training reduce the number of general dental practices which provide an anaesthesia service. These recommendations will be referred to throughout the text. 2 Some of the recommendations have far-reaching implications for the provision of dental anaesthesia. These include the recommendations that all anaesthetics must be administered by accredited anaesthetists, that anaesthetic training must include specific training in dental anaesthesia and that 'The same standards in respect to personnel, premises and equipment must apply irrespective of where the general anaesthetic is administered.' The problems associated with dental chair anaesthesia are similar to those of any outpatient procedure. However, there is an additional problem of maintenance of the airway during surgery in the mouth. The areas of importance can be addressed under the broad headings of patient selection, equipment and facilities, anaesthetic technique and postoperative care.