Informed Consent | General Anesthesia

General anesthesia means to place a person in a controlled unconscious state using medications that are administered either intravenously or through the lungs as inhaled gases. In addition to the primary anesthetic drugs, other medications are given as the need arises to assist in maintaining the patient in an optimal state.

During the time the patient is anesthetized, monitors are connected to record the patient’s vital signs, the eyes are taped shut so that they do not dry, an Intravenous line is established to administer medications, and an airway is placed through the nose to ensure adequate oxygen supply.

After the dental treatment is completed, the patient is transferred to the recovery area where they are continually monitored until they are sufficiently awake and all the tubes and monitors can be removed. At that time the parents or caretakers are invited to be present as the patient continues to awaken from the anesthetic. When the patient is able to open their eyes and respond to instructions they are allowed to go home with their parent or caretaker.

Benefits and alternatives

Patients who are very young, very afraid, have certain physical or medical conditions, or require certain types of dental work can be treated under general anesthesia more safely than using local anesthetic alone. In such cases there is often no alternative to general anesthesia except physical restraint that can leave long lasting fears, phobias, and emotional scars.

Common risks

  1. Reaction to anesthetic medications: In rare instances patients have an allergic reaction to the anesthetic medications, which may require emergency medical attention. In such an occasion, Dr. Pierson and his staff are trained and equipped to provide emergency care until the patient is transferred to the hospital.
  2. Aspiration: In the past, patients have been known to vomit stomach contents during the anesthesia that could be inhaled into the lungs. This could block the lung passages or the acidity of this material may chemically burn the lungs. This is the reason that it is so important that the patient ‘s stomach is empty when they come for treatment.
  3. Nausea and/or vomiting: Some patients feel nauseous after a general anesthetic and may vomit. Usually this is not a major problem and stops without treatment, however if it is severe, treatment may be necessary to prevent dehydration.
  4. Pain and/or bruising at IV site: Sometimes it is difficult to establish an intravenous site and several attempts are made. These sites can bruise and be uncomfortable for a few days. They heal without treatment, however applications of hot and cold compresses can speed the process.
  5. Tape reactions: Sometimes a slight skin reaction can appear around the eyes, cheeks, forehead, hand, or any other place tape touches the skin. Usually they are minor reactions that only last a few hours. However if they should blister or seem to be worsening or the patient experiences any difficulty breathing, an allergic reaction should be suspected and the patient should seek medical consultation immediately.
  6. Fever: Sometimes patients experience a slight fever for a few hours after a general anesthetic. This condition usually stops on its own however an anti-inflammatory medicine such as Tylenol or Advil often speeds the process.

Consequences of not performing treatment

This treatment will enable the dental treatment to be done so that there will not be a worsening of the dental disease resulting in further breakdown, infection, or loss of function.

Every reasonable effort will be made to ensure that the patient will be treated properly, although it is not possible to guarantee perfect results. By signing the consent form, you acknowledge that you have received adequate information about the proposed treatment, that you understand this information and that all of your questions have been answered fully.

Pre-Operative Instructions

  1. DIET: A rare but serious complication that can occur under general anesthesia is aspiration (see Common risks #2). If the patient should vomit during the surgery and some of the material from their stomach goes into the lungs, it can be very serious even causing death. Therefore, it is extremely important that the stomach is empty when they come for surgery. They must not eat or drink any food for six (6) hours before the surgery. Small amounts of clear liquids like water can be taken up to two (2) hours before the surgery. Nothing should go into the mouth the last two (2) hours before the surgery. This rule is strictly observed and if violated can result in either cancellation or postponement of the treatment.
  2. CLOTHING: We do not undress the patient for the operation unless they are wearing something like a single piece outfit (tight dress or jumpsuit) that makes it difficult to place the monitors. Short sleeved, loose fitting two-piece outfits (shorts & T-shirts) are the best for them to wear. All jewelry should be removed prior to surgery and young children should wear diapers.
  3. MEDICATIONS: If the patient is currently taking medication for any reason, they should continue to take it according to their routine schedule unless instructed differently. If they must take a liquid with their medication it should be water only. It is best if you can show us a sample of the medication in its original container. At minimum, please inform us of what medicine the patient has taken the day of surgery.
  4. ILLNESS: Please notify us if the patient develops a cold, fever, runny nose, asthma or other illness. It is unwise to have a general anesthetic when suffering from an infection or illness. If the patient has a change in their health the day before or the day of surgery, please call us. If necessary, we can reschedule the appointment and save you an unnecessary trip.
  5. DAY OF SURGERY: Due to our small waiting room and the fact that the patient may need your undivided attention on the way home it is not recommended that you bring other small children unless there is another adult to assist. Plan on at least 3 hours from the time you arrive until you can leave. The patient should use the bathroom just before the operation to minimize the chance of wetting themselves while asleep. We do not allow family members to stay in the operating room after the patient is asleep.