Dental anaesthesia in Siriraj Hospital.

ABSTRACT

We reported the use of anaesthesia for dental treatment and surgery in 60 patients during September 1989 – December 1990. Most of the pathological indications comprised dental caries, impacted teeth, bone exostosis and infection in the oral cavity. Twenty percent of the patients came to our unit in order to avoid dental treatment under local infiltration with local anaesthetics. Forty-seven percent of patients had associated diseases and 21 percent had taken regular medication. The laboratory investigation is helpful only when was indicated by history and physical examination. A routine complete blood count should be replaced with hematocrit and a routine urine examination should be abandoned. The method of payment for treatment was cash out of pocket 64.9 percent, reimbursement 28.1 percent and financial assistances 7.1 percent, but the fee for anaesthesia had to be reduced because costs of anaesthesia were much more than local infiltration. General anaesthesia was used in 58 patients and intravenous sedation in 2 patients. Monitoring included pulse oximetry, automated blood pressure, EKG, stethoscopy, because the anaesthesiologist and the dentist had to share the airway and the patients had to be ambulatory within a few hours. Anaesthetic time was less than 90 minutes in 81.7 percent of the patients and recovery time was less than three hours in 73.3 percent of them. Only minor complications were noted in recovery time was 13.1 percent and nausea 11.7 percent. Ninety-six percent of the patients were satisfied with the result of treatment under anaesthesia. Therefore, while dental anaesthesia needs the presence of competent anaesthesiologists and close monitoring, it can help dentists in performing their work and overcoming the inconvenience of the patients.