PRE-OPERATIVE INSTRUCTIONS
for Oral Surgery

[   In-house Surgical Suite   |  Anesthesia   ]

• If you are taking prescription medications prior to your surgery, please call our office and tell the nurse.  Generally, we want you to take your medicines prior to surgery, but it depends on the type of medication prescribed.  
• If you are taking the medication Coumadin,  please inform our staff as you will need a blood test a few days before surgery to check your bleeding time (INR).
• You should wear loose fitting (preferably short) sleeves to facilitate the application of monitoring devices during surgery.
• Please bring your insurance and other necessary forms.
• If you have a heart murmur or any condition that requires pre-medication, please make arrangement with your physician or call our office and speak with one of our nurses.
• If you are having intravenous sedation or general anesthesia:
  1.  You should have nothing to eat or drink, including water, for 8  hours before surgery. 
  2.  You will need someone to wait with you and drive you home after the surgery
  3.  Your escort should stay with you for 12-24 hrs. until you are fully awake.  
  4.  You should not drive for 12-24 hours after surgery.

IN-HOUSE SURGERY
Drs. Smith, Gray and Morris have had extensive years of surgical experience.  Each surgeon had complete training in Advanced Cardiac Life Support.  They are also thoroughly knowledgeable in pain and anxiety control.   Their efforts are aimed at providing you the highest standards of care and safety while making your surgical experience as pleasant and stress free as possible.

Our office is a surgery suite setting.  It is very much like the hospital but smaller and more relaxed for the patient.  Our equipment is like what you see in the hospital.  As you arrive, one of our nurses will explain the equipment's purpose to you and connect the necessary monitors to evaluate you during your surgery.  You will typically be monitored with a  blood pressure cuff, a pulse oximeter (to assure adequate oxygen in your blood) and an electrocardiogram (EKG) as deemed necessary.

You will most likely be given medication via intravenous infusion (IV) in your arm or hand.  This will help you to relax and possibly fall asleep.  We will use nitrous oxide (laughing gas) to relax you if you are anxious about the IV sedation or have a fear of needles.  After the procedure as you become more alert, the IV will be removed.   Our nurses will explain the post operative instructions and give you and the person driving you home written instructions and a prescription for pain medication as needed.

Our practice follows the guidelines as set out by the Center for Disease Control concerning all sterilization and cleaning procedures for your safety and peace of mind.  If you have any questions, please feel free to ask us. We value your comments and pledge our dedication to your good dental health.

ANESTHESIA 
Every oral and maxillofacial surgeon during his residency has received formal anesthesia training with the department of anesthesia in the hospital.  A surgeon must adhere to and practice strict  guidelines regarding IV sedation, general anesthesia,  airway management and intubation techniques.  The state of Kentucky monitors the administration of anesthesia in private offices to insure patient safety.

The method of anesthesia that is best for you will be determined by your  surgeon.

• Local anesthesia   (Novocaine)  
   is introduced by way of an injection into the surgical site. The local anesthetic numbs the area and allows your surgery to be performed with you awake. 
• Nitrous oxide and oxygen analgesia   (Laughing gas)
   is introduced by way of a nasal mask. The gas inhaled will put you in a more relaxed, euphoric state, but you are not asleep. Local anesthesia will also be given. 
• Intravenous sedation
   induces a state whereby most patients become so relaxed that they fall asleep on their own. This technique requires medication to be introduced through one of your veins (intravenously). A local anesthetic is also given after you have become more relaxed. 
• General Anesthesia  (Fully Asleep)
   is achieved upon the administration of medication intravenously. The medication actually puts you to sleep and keeps you asleep during surgery.

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