Nitrous Oxide or Laughing Gas
Nitrous oxide or laughing gas is an analgesic and helps provide some mild sedation and pain relief during the procedure. For nitrous oxide analgesia it is recommended that the patient have nothing to eat or drink approximately 3 hours ahead of time. There is no need for the patient to be escorted home if nitrous oxide and local anesthesia only are being used.
Intravenous Sedation and General Anesthesia
Intravenous sedation and general anesthesia are the most common types of supplemental anesthesia that we use. With intravenous sedation or conscious sedation, also known as twilight sleep, an intravenous catheter is placed and intravenous fluids are administered. The patient is fully monitored as described. Medications such as Midazolam (a sedative and amnesia causing drug), Fentanyl (a narcotic for pain relief) and Propofol or another similar medication, which causes the patient to be asleep are used. Theses drugs are used alone or in combination with one another to produce a desired effect. The dosages are based on the patient's size, age, health status; level of sedation required or requested length of procedure, etc. The patient is sedated, relaxed, and may have no awareness or recollection of the procedure being done including the administration of local anesthesia which occurs following the administration of the IV sedation. IV general anesthesia is typically referred to as a deeper level of sedation where the patient is essentially asleep during the procedure but breathing without assistance.
General anesthesia, as is administered in the hospital by way of intubations and inhalation of volatile anesthesia, is administered by board certified anesthesiologist for any surgery that requires this level of anesthesia.