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Dental Anesthesia

Anesthesia / What is the difference?

11/07/2005

Question:

What is the difference between General Anesthesia & IV Sedation?

Answer:

General Anesthesia is basically being "completely out" where there is virtually no chance of recall from the procedure. This can be done with or without a breathing tube and with either gas or intravenous drugs or both. This more profound level of unconsciousness can result in the need for support of breathing and adjustment of blood pressure and heart rate. Of course, this is the job of the independent anesthesiologist who can do this very predictably.

Intravenous sedation can be either "deep sedation" or "conscious sedation." In conscious sedation, the patient is awake, but drugs can be given which produce a reasonable likelihood of amnesia for most, if not all of, the procedure. The patient can respond to verbal commands or mild physical stimulation (like shaking someone awake from sleep). If there is interruption of breathing, the patient should be able to be gently provoked to breath without support.

Deep sedation is a state in between the two described above. There may be brief periods of light general anesthesia for stimulating portions of the procedure, like local anesthetic injection and in the case of dentistry, extraction of painful teeth. The remainder of the time, the patient is in a conscious sedation state. Although the chance of recall is slight with deep sedation, it can occur, and only general anesthesia can provide nearly complete assurance of lack of procedural recall.

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Response by:

Steven I Ganzberg, SB, DMD, MS Steven I Ganzberg, SB, DMD, MS
Formerly, Clinical Professor of Dentistry
College of Dentistry
The Ohio State University