ABSTRACT
The safe treatment of patients with chronic obstructive pulmonary disease (COPD) in dental office office-based settings can be quite complex without a current understanding of the etiology, course, severity, and current treatment modalities of the disease. The additional concerns of providing sedation and/or general anesthesia to patients with COPD in settings outside of a hospital demand thorough investigation of individual patient presentation and realistic development of planned treatment that patients suffering from this respiratory condition can tolerate. Along with other co-morbidities, such as advanced age and potential significant cardiovascular compromise, the dental practitioner providing sedation or general anesthesia must tailor any treatment plan to address multiple organ systems and mitigate risks of precipitating acute respiratory failure from inadequate pain and/or anxiety control. Part I of this article covered the epidemiology, etiology, and pathophysiology of COPD. Patient considerations in the preoperative period were also reviewed. Part II will cover which patients are acceptable for sedation/general anesthesia in the dental office-based setting as well as sedation/general anesthesia techniques that may be considered. Postoperative care will also be reviewed.
Subject(s)
Anesthesia, Dental , Anesthesia, General , Pulmonary Disease, Chronic Obstructive , Anesthesia, Dental/methods , Anesthesia, General/methods , Conscious Sedation , Dental Offices , Dentists , Humans , Pulmonary Disease, Chronic Obstructive/complicationsSubject(s)
Anesthesia Recovery Period , Anesthesia, Dental/methods , Anesthesia, General/methods , Conscious Sedation/methods , Deep Sedation/methods , Delegation, Professional , Dental Assistants , Anesthesia, Dental/adverse effects , Anesthesia, Dental/standards , Anesthesia, General/adverse effects , Anesthesia, General/standards , Clinical Competence , Conscious Sedation/adverse effects , Conscious Sedation/standards , Deep Sedation/adverse effects , Deep Sedation/standards , Delegation, Professional/standards , Dental Assistants/standards , Humans , Patient Safety , Risk AssessmentABSTRACT
The safe treatment of patients with chronic obstructive pulmonary disease (COPD) in dental office-based settings can be quite complex without a current understanding of the etiology, course, severity, and treatment modalities of the disease. The additional concerns of providing sedation and/or general anesthesia to patients with COPD in settings outside of a hospital demand thorough investigation of individual patient presentation and realistic development of planned treatment that patients suffering from this respiratory condition can tolerate. Along with other comorbidities, such as advanced age and potential significant cardiovascular compromise, the dental practitioner providing sedation or general anesthesia must tailor any treatment plan to address multiple organ systems and mitigate risks of precipitating acute respiratory failure from inadequate pain and/or anxiety control. Part I of this article will cover the epidemiology, etiology, and pathophysiology of COPD. Patient evaluation in the preoperative period will also be reviewed. Part II will cover which patients are acceptable for sedation/general anesthesia in the dental office-based setting as well as sedation/general anesthesia techniques that may be considered.
