Nurse anesthesiologists, the first healthcare providers dedicated to the specialty of anesthesia, have their roots in the 1800s, when nurses first gave anesthesia to wounded soldiers on the battlefields of the Civil War. Today, Certified Registered Nurse Anesthesiologists (CRNAs) are master’s or doctorate prepared advanced practice nurses who enjoy a high degree of autonomy and professional respect. CRNAs provide anesthetics to patients in every practice setting, and for every type of surgery or procedure. They are the sole anesthesia providers in nearly all rural hospitals, and the main provider of anesthesia in the majority of hospitals and surgery centers.
In general we would say that dental sedation, like any medical procedure, carries a certain amount of risk. Most adverse events and deaths that occur in dental offices occur as the result of an overdose with oral sedation or lack of a dedicated anesthesia professional administering the IV sedation. But you can rest assured that we never take that lightly. Your safety and comfort remains our highest priority from the moment you arrive until it is time for you to depart. We never leave your side. We watch over you continuously while your dentist or oral surgeon works. It may help you to put your risk into perspective to think of it this way: your risk in the dental chair is minimal compared to your risk in your car as you travel to your appointment.
Upon lying down in the dental chair, a CRNA will assess you and confirm all preoperative information. An assistant will offer blankets to wrap around you so you feel comfortable and warm. You will be placed on a vital sign monitor that will allow the CRNA to continuously monitor your blood pressure, heart rate, oxygen saturation, and presences of end tidal carbon dioxide. Oxygen will be provided via a nasal cannula that will be placed. A small IV will be placed in which sedation medication will begin to be administered.
Upon administration of the IV medication, you will quickly begin to feel relaxed and at ease. The sights, smells and noises around you will dissipate. While the dentist works, the CRNA’s sole responsibility is to make sure you are safe and comfortable as if you were in an operating room. Many times your dentist or oral surgeon can usually accomplish a significantly larger amount of high-quality dentistry while you are sedated. Because your jaw, tongue and facial muscles are relaxed as well, your dentist can more efficiently provide you with a higher level of treatment.
At the end of the procedure, the medication will be discontinued and once you have recovered you will be allowed to be discharged. All patients must have an adult driver to assist them home.
There is no set amount of recovery time because every patient is different. However, the IV medications we use are eliminated by the body very rapidly and many patients begin to feel alert soon after the IV medication is stopped. Most patients are ready to leave the office within 15-30 minutes. You should not drive or operate heavy machinery for at least 24 hours after the end of your appointment.
Many times, IV sedation administered by a CRNA maybe a safer choice than other forms of dental sedation for patients with complex medical conditions. Due to the rapid onset of IV medications, the CRNA will be able to precisely adjust the IV sedation to your medical condition. In certain circumstances, a medical clearance from your physician may be necessary before the procedure.
We use a variety of equipment to keep you safe. We have all of the same equipment and emergency medications that you would find in the operating room. This includes emergency airway devices for all ages and advanced cardiac life support resuscitation medications.
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