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Anesthesia Complications in the Dental Office

Anesthesia Complications in the Dental Office covers a wide range of topics beneficial to all levels of anesthesia care providers, be they students, residents, academics, or clinical prac-
titioners. The book begins with the preoperative issues that play a role in evaluating the difficulties in safeguarding the patients, many of whom present with medical problems that were far less common a couple of years ago.

Modern medicine has extended our longevity but now the patients present to our offices with an extended list of medications for diseases that were less recognized in the past
decades and they are often diagnosed with behavioral and obesity
issues.
Pharmacology of anesthesia practice has frequently met the challenges of modern societal problems with newer, more efficient shorter acting agents than what was available in the 1960s and 1970s.

These are discussed in the middle chapters of the book. While basic physiology has not changed much, our understanding of the new drugs available and the way they affect the safety of patients under anesthesia has. Since the 1980s, monitoring the effects of all anesthesia drugs with pulse oximetry, capnography, and even bispectral analysis for special situations has set the scene for improved safety.

1. Despite the improvement in airway management techniques and skills learned, complications, both common and far less common, are still of great concern. The final chapters in the book deal with the need for prompt recognition and treatment of anesthesia-related urgencies and emergencies. While death “is not an option” so tospeak, it is discussed and put in proper perspective when comparing the risks of air travel, driving, and even exercising to those of undergoing anesthesia in the office.
2. This first edition of Anesthesia Complication in the Dental Office offers a wide variety of subject material and should be on the library shelf of every anesthesia care provider working in the dental office. The names of the contributors are well known in academia and in clinical practice and have great credibility in the field of office-based anesthesia practice to make this book worthy of acquiring.

Table And Contents

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. Bosac

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