Dentist uses Nitrous Oxide?

Mxsmanic wrote:
Mark & Steven Bornfeld DDS writes:


Most oral surgeons I know use an ultrashort acting barbiturate for
induction. The nitrous potentiates this, but it is the IV barbiturate that
is really the general anesthetic agent.


I'd guess that the nitrous oxide made me woozy in about 30 seconds, and
I think I was out for only about 20 minutes under the barbiturate (I
think he told me it was Brevital, but I'm not sure).

That's what was used "in the day"--it may still be the drug of choice
for the OMFS.



Cases in the OR got nasotracheal intubation, and an inhalation
agent--usually halothane or ethrane.


I didn't even know you could intubate someone through the nose. It
sounds difficult to do. Even intubation through the mouth is said to be
pesky enough that an anesthesiologist is often called in just to do
that.

I had a month rotation in anesthesia. My first try on an endotracheal
intubation I did neatly down the esophagus. They let me bag the guy and
inflate the stomach before they told me. Nice.
Like anything else, the good anesthesiologists make it look easy.


I assume, then, that this nasotracheal intubation leaves the mouth
unencumbered while keeping a sealed path to the lungs for the
anesthesia?

Yes.


Another thing I noticed about the wisdom extraction was: no post-op
nausea. I had a simple IV induction for a hernia operation, and
whatever he used (inhalant of some kind, I presume) left me sick for 24
hours. I was worried about the extraction for this reason, but other
than an odd sort of fatigue (I felt fatigued, but when I tried to lay
down to sleep, I didn't fall asleep), I experienced no aftereffects,
which was fine with me.

I think nausea isn't too common, still anyone getting GA MUST have an
empty stomach before surgery.


Indeed, had I known that removing bony impacted wisdom teeth four at a
time could be such a breeze, I wouldn't have endured the discomfort of
those teeth for so long.

Glad for you it went easily. Frequently it does. Except when it doesn't.

Steve

Wendy wrote:
snip
. (I'm slightly anemic and so are both of my other children - we
just are low normal in our family.) I cannot believe that these people
want to do yet another stick on this child without a damn good reason!

I must stay that I was always borderline anemic too, and dd#1 was also when
she was a toddler. She had lots of needlesticks and didn't ever complain
about it. I had lots and lots of needles as a child, because the treatment
for asthma then was shots 3x a week, which my dad gave me for years. I
think it hurt him more than me. He really hated to do it.

I hate that commercial about how heartwrenching it is for a 3 yo to cry
about needlesticks. I just think that is so lame. If you have the choice
of testing your blood or dying, you test the blood.

I do agree that there's no real reason to check Wendy's child again for
that. I am also of the opinion that doctors do not really know how to
treat anemia - nothing they ever gave me helped - iron pills and even a
complete hysterectomy did not do it. And I think dd got better on her own
in spite of what they did rather than because of it.

My ds's first child had leukemia and was in the hospital a lot before he
died and they put a thing in his chest to deliver drugs and chemo. He
never complained about that but he hated to have his temperature taken in
his ear. We couldn't figure out why that was such a problem for him
because it's really pretty non-invasive.


grandma Rosalie

Thalesemia ? ? ? ? (sp?)

--
~+--~+--~+--~+--~+--
Stephen Mancuso, D.D.S.
Troy, Michigan, USA
DrSteve Q Mancusodds.com
{change the center letter to "at" (and drop two spaces) for email}
.................................................. ...

This posting is intended for informational or conversational purposes only.
Always seek the opinion of a licensed dental professional before acting on
the advice or opinion expressed here. Only a dentist who has examined you
in person can diagnose your problems and make decisions which will affect
your health.
.......................
Please ignore j..d...
~~~~``````````#####----

"Rosalie B." wrote in message
...
Wendy wrote:
snip
. (I'm slightly anemic and so are both of my other children - we
just are low normal in our family.) I cannot believe that these people
want to do yet another stick on this child without a damn good reason!

I must stay that I was always borderline anemic too, and dd#1 was also
when
she was a toddler. She had lots of needlesticks and didn't ever complain
about it. I had lots and lots of needles as a child, because the
treatment
for asthma then was shots 3x a week, which my dad gave me for years. I
think it hurt him more than me. He really hated to do it.

I hate that commercial about how heartwrenching it is for a 3 yo to cry
about needlesticks. I just think that is so lame. If you have the choice
of testing your blood or dying, you test the blood.

I do agree that there's no real reason to check Wendy's child again for
that. I am also of the opinion that doctors do not really know how to
treat anemia - nothing they ever gave me helped - iron pills and even a
complete hysterectomy did not do it. And I think dd got better on her own
in spite of what they did rather than because of it.

My ds's first child had leukemia and was in the hospital a lot before he
died and they put a thing in his chest to deliver drugs and chemo. He
never complained about that but he hated to have his temperature taken in
his ear. We couldn't figure out why that was such a problem for him
because it's really pretty non-invasive.


grandma Rosalie

On Wed, 01 Oct 2003 11:46:24 GMT, "Dr Steve" wrote:

Thalesemia ? ? ? ? (sp?)


Porphyria is another royal disease with historical implications. One
of the symptoms of this disease is bouts of madness and it is believed
that King George III of England suffered from this genetic disorder
which may have gone back to Mary, Queen of Scots.




--
Joel M. Eichen, .
Philadelphia PA

DISCLAIMER FOLLOWS:

*********

Dental health-related material
is provided for information purposes
only and does not necessarily
represent endorsement by or an official
position of the SciMedDentistry gang
or any other official agency either
actual or fictitious or Steve Mancuso.

Advice on the treatment or care
of an individual patient should
be obtained through consultation
with a dentist who has examined
that patient or is familiar with
that patient's dental history.

STANDARD DISCLAIMER

Mxsmanic wrote in
news
The one thing I'm curious about here is: Don't most forms of GA involve
an inhaled anesthetic agent? And if so, doesn't that interfere with the
dental work? I mean, usually you intubate a patient for GA with
inhalants, but I don't see how you can do that for dental work without
crowding out the dentist. So how is it done?


Easy-- he probably doesn't use gas agents!

Scott

"Joel M. Eichen D.D.S." wrote:

On Wed, 01 Oct 2003 11:46:24 GMT, "Dr Steve" wrote:

Thalesemia ? ? ? ? (sp?)

Porphyria is another royal disease with historical implications. One
of the symptoms of this disease is bouts of madness and it is believed
that King George III of England suffered from this genetic disorder
which may have gone back to Mary, Queen of Scots.

IIRC, the porphyria is also associated with excessive facial hair and
it is speculated that someone with this condition inspired the legend of
the wolf man.

Steve



--
Joel M. Eichen, .
Philadelphia PA

DISCLAIMER FOLLOWS:

*********

Dental health-related material
is provided for information purposes
only and does not necessarily
represent endorsement by or an official
position of the SciMedDentistry gang
or any other official agency either
actual or fictitious or Steve Mancuso.

Advice on the treatment or care
of an individual patient should
be obtained through consultation
with a dentist who has examined
that patient or is familiar with
that patient's dental history.

STANDARD DISCLAIMER

--
Mark & Steven Bornfeld DDS
Brooklyn, NY
718-258-5001
http://www.dentaltwins.com

Wendy wrote:

In misc.kids madiba wrote:
I don't think giving him anti-anxiety meds before a procedure is such a
bad idea.

After having heard the whole story, you're probably right. But there are
plenty of tranquillisers out there besides Valium.

Valium is all I know and I haven't even been able to get that for
him. The first dentist didn't work on kids who needed that much
work. The second dentist wouldn't use valium because he used NO. The
third dentist didn't use sedatives at all and didn't want to. We're
headed for the fourth dentist and I tried to prescreen her on the phone to
discover if she'd prescribe a sedative before I make the 1/2 day journey
to her office for his 11th visit to the dentist in 4 months, but her
assistant just said she has in the past. I'm taking that as a hopeful
sign.

Is there any other sedative I should discuss with her?
Klonopin (clonazepam) is very safe, the tranquillising effect is not as
strong. Its mainly for kids that have seizures, but it also helps
against pain.
If he really is a bundle of nerves Versed Syrup (midazolam) will do the
trick. But this is a strong tranquilliser so you need to have a dentist
with monitoring equipment, as you should with Valium too. I found it to
be excellent for people getting bone marrow core biopsies (in adults).
By the way, I had a long talk with his pediatrician's nurse today, who
recommended yet a 5th dentist, but no solution to the anxiety. In fact,
he's slightly anemic and they want to draw more blood in a retest. I said
the hell with that, let's just assume he IS anemic and not bother testing
him again. (I'm slightly anemic and so are both of my other children - we
just are low normal in our family.) I cannot believe that these people
want to do yet another stick on this child without a damn good reason!

I get the feeling the morphine trips in hospital sensitised him. Careful
when he reaches his teens..

Sigh. Okay, what's THIS new danger?
I meant he's experienced the blissful painless state that morphine puts
you in and is reluctant to settle for anything less now.
Teens? - the drugs thing.
Wendy, who needs a new hobby


--
madiba

In misc.kids madiba wrote:
I get the feeling the morphine trips in hospital sensitised him. Careful
when he reaches his teens..

Sigh. Okay, what's THIS new danger?

I meant he's experienced the blissful painless state that morphine puts
you in and is reluctant to settle for anything less now.

Ah, that makes sense. Well, he was not quite 3 when he was on his (all
too infrequent) morphine trips, and I think there's a good chance he
doesn't even know that the blissful state was caused by something named
morphine. He certainly hasn't shown signs of becoming a daycare
drug-addict at the moment (sometimes he gets up in the night but I don't
think it's to knock over any drug stores.) :-)

Teens? - the drugs thing.

All joking aside, that's a good point. I'll keep my eyes open.

Wendy

MAdiba,

Wrong again, Klnopin is a benzodiazepine just as Valium. Both have
antiseizure effects. In fact Valium is the drug of choice for status
epilepticus. NEITHER will relieve pain. Neither have any analgesic
property....



Better get that book....



madiba wrote:

Wendy wrote:


In misc.kids madiba wrote:

I don't think giving him anti-anxiety meds before a procedure is such a
bad idea.

After having heard the whole story, you're probably right. But there are
plenty of tranquillisers out there besides Valium.

Valium is all I know and I haven't even been able to get that for
him. The first dentist didn't work on kids who needed that much
work. The second dentist wouldn't use valium because he used NO. The
third dentist didn't use sedatives at all and didn't want to. We're
headed for the fourth dentist and I tried to prescreen her on the phone to
discover if she'd prescribe a sedative before I make the 1/2 day journey
to her office for his 11th visit to the dentist in 4 months, but her
assistant just said she has in the past. I'm taking that as a hopeful
sign.

Is there any other sedative I should discuss with her?

Klonopin (clonazepam) is very safe, the tranquillising effect is not as
strong. Its mainly for kids that have seizures, but it also helps
against pain.
If he really is a bundle of nerves Versed Syrup (midazolam) will do the
trick. But this is a strong tranquilliser so you need to have a dentist
with monitoring equipment, as you should with Valium too. I found it to
be excellent for people getting bone marrow core biopsies (in adults).

By the way, I had a long talk with his pediatrician's nurse today, who
recommended yet a 5th dentist, but no solution to the anxiety. In fact,
he's slightly anemic and they want to draw more blood in a retest. I said
the hell with that, let's just assume he IS anemic and not bother testing
him again. (I'm slightly anemic and so are both of my other children - we
just are low normal in our family.) I cannot believe that these people
want to do yet another stick on this child without a damn good reason!


I get the feeling the morphine trips in hospital sensitised him. Careful
when he reaches his teens..

Sigh. Okay, what's THIS new danger?

I meant he's experienced the blissful painless state that morphine puts
you in and is reluctant to settle for anything less now.
Teens? - the drugs thing.

Wendy, who needs a new hobby

V35B wrote:

MAdiba,

Wrong again, Klnopin is a benzodiazepine just as Valium. Both have
antiseizure effects. In fact Valium is the drug of choice for status
epilepticus. NEITHER will relieve pain. Neither have any analgesic
property....

Look genius, we were discussing tranquillizers. Benzods are the best
tranquillizers. Klonopin is safer because there is less resp. depr. than
in valium. It IS included in pain management schedules, look it up.

Better get that book....
Go back to school.


--
madiba