Anesthesia Complications in the Dental Office

Description

Anesthetic complications, which range from simple annoyances to patient mortality, are inevitable, given the many and complex interactions of doctor, patient, personnel, and facility. Anesthesia Complications in the Dental Office helps dentists minimize the frequency and severity of adverse events by providing concise and clinically relevant information that can be put to everyday use.

Anesthesia Complications in the Dental Office presents the most up-to-date information on treating anesthesia complications and medical emergencies. Drs. Bosack and Lieblich and a team of expert contributors discuss patient risk assessment; considerations for special needs and medically compromised patients; routinely administered anesthetic agents; adversities that can arise before, during, and after administration of anesthesia; and emergency drugs and equipment. A must-have reference for every dental office.

Table of Contents

Contributors
Foreword
Preface
Acknowledgment

Section 1: Introduction
1 Anesthetic complications—how bad things happen 3
Robert C. Bosack

Section 2: Patient risk assessment
2 History and physical evaluation 9
Kyle Kramer, Trevor Treasure, Charles Kates, Carrie Klene and Jeffrey Bennett
3 Laboratory evaluation 15
Kyle Kramer and Jeffrey Bennett
4 NPO guidelines 19
Kyle Kramer and Jeffrey Bennett

Section 3: Anesthetic considerations for special patients
5 Anesthetic considerations for patients with cardiovascular disease 25
Erik Anderson and Robert Bosack
6 Anesthetic considerations for patients with respiratory disease 49
Robert C. Bosack and Zak Messieha
7 Anesthetic considerations for patients with endocrinopathies 61
Daniel Sarasin Kevin McCann and Robert Bosack
8 Anesthetic considerations for patients with psychiatric illness 71
Daniel L. Orr, Robert C. Bosack and John Meiszner
9 Anesthetic considerations for patients with neurologic disease 79
Joseph A. Giovannitti
10 Anesthetic considerations for patients with hepatic disease 85
Jeffrey Miller and Stuart Lieblich
11 Anesthetic considerations for patients with renal disease 89
Marci H. Levine and Andrea Schreiber
12 Anesthetic considerations for pediatric patients 93
Michael Rollert and Morton Rosenberg
13 Anesthetic considerations for geriatric patients 97
Andrea Schreiber and Peter M. Tan
14 Anesthetic considerations for patients with bleeding disorders 103
O. Ross Beirne
15 Anesthetic considerations for patients with cancer 113
Andrea M. Fonner and Robert C. Bosack
16 Anesthetic considerations for pregnant and early postpartum patients 117
Robert C. Bosack

Section 4: Review of anesthetic agents
17 Clinical principles of anesthetic pharmacology 123
Richard C. Robert
18 Local anesthetic pharmacology 129
Roy L. Stevens and Robert C. Bosack
19 Enteral sedation agents 133
Richard C. Robert
20 Parenteral anesthetic agents 135
Richard C. Robert
21 Inhalational anesthetic agents 143
Charles Kates, Douglas Anderson, Richard Shamo and Robert Bosack
22 Antimuscarinics and antihistamines 151
Richard C. Robert
23 Drug interactions 155
Kyle Kramer and Richard C. Robert

Section 5: Monitoring
24 Limitations of patient monitoring during office-based anesthesia 163
Robert C. Bosack and Ken Lee

Section 6: Preparation for adversity
25 Crisis resource management 173
Joseph Kras
26 Simulation in dental anesthesia 177
Joseph Kras
27 Airway adjuncts 181
H.William Gottschalk
28 Intravenous fluids 185
Cara Riley, Kyle Kramer and Jeffrey Bennett
29 Emergency drugs 189
Daniel A. Haas

Section 7: Anesthetic adversity
30 Failed sedation 201
Roy L. Stevens and Kenneth L. Reed
31 Complications with the use of local anesthetics 207
M. Anthony Pogrel, Roy L. Stevens, Robert C. Bosack and Timothy Orr
32 Anesthetic adversity – cardiovascular problems 219
Robert C. Bosack and Edward C. Adlesic
33 Anesthetic adversity—respiratory problems 231
Charles F. Cangemi, Edward C. Adlesic and Robert C. Bosack
34 Allergy and anaphylaxis 251
H.William Gottschalk and Robert C. Bosack
35 Anesthetic adversity–neurologic problems 257
Michael Trofa and Robert C. Bosack
36 Acute adverse cognitive behavioral and neuromuscular changes 261
Edward Adlesic, Douglas Anderson, Robert Bosack, Daniel L. Orr and Steven Ganzberg
37 Anesthetic problems involving vasculature 271
Stuart Lieblich

Section 8: Post-anesthetic adversity
38 Nausea and vomiting 277
Edward Adlesic
39 Post-anesthetic recall of intraoperative awareness 283
Robert C. Bosack
40 Delayed awakening from anesthesia 287
Stuart E. Lieblich
41 Safe discharge after office-based anesthesia 291
Stuart Lieblich and Peter M. Tan

Section 9: When bad things happen
42 Morbidity and mortality 295
Lewis Estabrooks
43 Death in the chair: a dentist’s nightmare 299
Glen Crick
44 Legal issues of anesthesia complications: risks or malpractice 307
Arthur W. Curley

Section 10: When should you say no
45 When should you say no? 315
Andrew Herlich and Robert C. Bosack

Section 11: Appendices
Appendix A A pilot’s perspective on crisis resource management 323
David Yock

Appendix B Medical emergency manual for the general practitioner 325
Robert C. Bosack

Appendix C Malignant hyperthermia Q & A 337
Edward C. Adlesic and Steven I. Ganzberg

Index 339

Author Information

Robert C. Bosack, DDS, is an oral and maxillofacial surgeon and clinical assistant professor at the University of Illinois College of Dentistry. He has served as an examiner for the American Board of Oral and Maxillofacial Surgery, and has served on the board of directors of the National Dental Board of Anesthesiology. He is the executive director of Dental Anesthesia Online. Dr. Bosack speaks at national dental and anesthesia conferences and has written professional articles and the book Medical Emergencies in the Dental Office. He maintains a private practice in Orland Park, Illinois.

Stuart Lieblich, DMD, is clinical professor in the Division of Oral and Maxillofacial Surgery at the University of Connecticut School of Dental Medicine. He is a Past President of the American Dental Society of Anesthesiology and a past Director of the American Board of Oral and Maxillofacial Surgery. He serves on the editorial board of 3 major journals, has written more than 20 textbook chapters, and is an invited speaker at national conferences. Dr. Lieblich maintains a private practice in Avon, Connecticut.