4.1. General Anesthesia
The contemporary stage of medical scientific and practical evolution brings the possibility of pain relief for any necessary intervention in dentistry, regarding the facial area, bones of the facial part of the skull, organs of the oral cavity.
Anesthesia (from Greek anaesthesia ― insensitivity) includes such methods as general, local, and combined anesthesia. Combined anesthesia is determined as a combination of local and general anesthesia, local anesthesia with neuroleptanalgesia, general anesthesia with neuroleptanalgesia, local anesthesia with ataralgesia, etc. Most of the short-term operations in practical oral surgery are performed under local anesthesia including local anesthesia with premedication. Specificity of surgical interventions in the maxillofacial hospital leads to the choice of general anesthesia as the most preferable method, since inpatient surgical treatment is comparatively more long-lasting, traumatic, involves a bigger extent of manipulation, and impacts the organs and tissues, and it more frequently includes multi-stage operations. General anesthesia is also used in outpatient settings, providing treatment in patients with pathological psychological and emotional reactions, inflammatory diseases, trauma sequelae, in cases when local anesthesia cannot ensure the adequate power of pain relief during the operation. General anesthesia in dental patients has to be accomplished by an anesthesiologist.
General anesthesia is defined as a state of reversible inhibition of the central nervous system (CNS), that is achieved by drugs or the influence of physical or mental factors. It is characterized by the suppression of pain stimuli perception, achievement of the neural and vegetative blockade and muscle relaxation, the loss of consciousness, amnesia, maintaining the adequate gas exchange and blood circulation, the regulation of metabolic processes.
Combined anesthesia is used for the extensive maxillofacial surgical interventions while when performing the short-term oral surgery in terms of inpatient and outpatient medical care, inhalation or intravenous anesthesia is performed.
Methods for general anesthesia include:
- anesthesia (inhalation and non-inhalation);
- ataralgesia;
- central analgesia;
- neuroleptanalgesia;
- acupuncture;
- audio anesthesia;
- hypnosis.
Drugs are more often used, than physical factors (electronarcosis), with the aim of anesthesia performing. Medications that are indicated for general anesthesia are known as narcotic agents (general anesthetics). Anesthesia can be fulfilled with the use of one, two, or more narcotic agents and other drugs (combined, or multicomponent, potentiated anesthesia, etc.).