Question about anesthesia experience in Oral Surgeon's office..

[happylush]

Ok Kind of a long story... for all you anesthetists out there.. what do you think happened to me?

I had my wisdom teeth out about 2 years ago. I remember in the oral surgeon's office when I was out one of the nurses/assistants saying " her blood pressure is dropping' then I remember seeing a bunch of funky flashing colors in my head and my ears were ringing and then I was out again"... well I woke up and my shoes were off.. the oral surgeon wouldn't come and talk to me according to the assistant, and went into his office and slammed the door ( he has been known for his bad tempers).. she told me that everything went fine!

Well I went to my dentist last week... I happened to notice up on the screen a pop up box that says " anesthetic allergy"... I dont recall ever having a local anesthetic reaction or the dentist would have told me... so I am wondering what could have happened in the oral surgeons office? If it was something really serious wouldn't they have to have told me for future reference? Why did I wake up with my shoes off? LOL Did I almost die in the oral surgeons chair or something? It's kind of scary... Im questioning if something bad happened, such as me getting combative? Did I puke on him? What are some common anesthetic allergies seen in oral surgeon's offices? I dont know what kind of anesthesia was used, other than I know for sure I got some nitrous by mask before I was out...

Then again I went to have an appy a year ago and came out with no complications what-so ever..

[Marie_LPN, RN, LPN, RN]

Only way you're going to find this out is to go back to their office and ask.

[traumaRUs, MSN, APRN]

Yep - I agree. I went to the oral surgeon yesterday only to find that they use propofol in the outpatient setting. My oral surgeon is a board certified plastic surgeon/oral maxillo-facial dentist too. The assistant was an EMT! No RN.

I had cardiac and pulse oximetry and oxygen delivered via a nitrous oxide mask. I had to have an extensive I&D of an abscess and one tooth extracted. They used versed/fentanyl and propofol. I was quite nervous asking about the propofol since I was concerned that there was really no trained person monitoring ME.

At least in my little neck of the woods - its done in the oral surgeon's office. I called around prior to having this done and they all report they use propofol and are licensed by the state of IL to do so.

Is this the standard of care - providing propofol in an office where there is only an MD and no RN to monitor the patient?

[EricJRN, MSN, RN]

I had the same experience as you, Trauma. In Texas, dental providers (general dentists, oral surgeons, etc) are eligible for different types of anesthetic permits. Some aren't permitted for any anesthesia, some only for PO stuff, others for IV/deep sedation.

I thought my propofol and Demerol were truly wonderful, but I know that non-CRNA/MDA propofol is a hot topic on here at times.

To the OP - Scary to deal with an oral surgeon whose communication skills seem to be so poor!

[yoga crna]

From your description of the reaction, I think you had either an overdose or an intravascular injection of the local anesthetic. The ringing in the ears in one of the most common signs of overdose. It is VERY rare to be allergic (true allergy) to amide type of local anesthetics. But, it is rather common for oral surgeons to use high concentrations and have the symptoms you described. Also, commonly seen in dental settings are reactions to the epinephrine in the local. Hypertension and tachycardia are common signs of this.

It is my sense that you can safely have local anesthetics in the future, but you should always disclose your reaction and ask them to titrate to effect, so not to overdose.

It would be useful for you to look up the pharmacology of lidocaine.

Hope this helps.

Yoga

[VickyRN, MSN, DNP, RN]

we at allnurses cannot give medical advice, as this is outside the scope of this board. please consult the oral surgeon for a detailed explanation of what occurred. be sure to let all healthcare providers know of the reaction that you experienced (especially before any invasive or dental-type procedures). you also have the right to view your healthcare records, upon request, to find out specifically what anesthetic agents were used. best wishes to you :)