General Anesthesia Pre-operative Instructions
General Anesthesia Dentistry

General Anesthesia Pre-operative
Instructions and Premedication

Before the end of the pre-operative consultation the patient who will undergo treatment under general anesthesia is given a list of instructions to follow on the evening before and on the day of the procedure. Failure to follow these instructions, either the eating/drinking restrictions or medications and alcohol use, can cause serious complications and may be fatal.

General Anesthesia Pre-operative Instructions

The details of the pre-anesthesia instructions may differ from patient to patient depending on the individual’s health condition.

Food and drink restrictions

Typically a patient will not be allowed to eat or drink anything for several hours before anesthesia. An average of at least 6 hours fasting is required prior to the general anesthesia procedure. This period may be longer for patients with gastroesophageal reflux disease (GERD) or a history of vomiting.

Food and drink restrictions are necessary for reducing the possibility of regurgitation of stomach contents that can cause aspiration into the lungs with fatal consequences.

Patients are usually advised to avoid liquids and solid foods from midnight for a morning surgery or from 7 a.m. for an afternoon surgery under GA. Newer evidence suggest that having a cup of clear fluids (e.g. water or tea) up to 2 hours before GA is considered safe.

Medicine restrictions

Patients who have to take any medicines on a regular basis, such as diabetes or heart medicines, will be advised if they should take them normally or not, or if the dosage has to be adjusted. Use of any other medications without approval is strictly prohibited because it can lead to unexpected behavior of the anesthetic drugs.

Alcohol and smoking

Do not consume alcohol or smoke for 24 hours prior to your operation. Patients with respiratory problems should stop smoking for several days before treatment to reduce the risk of complications due to general anesthesia.

Escort arrangements

You must arrange for an adult friend or relative to be available to drive you home after the procedure.

Prescription of premedication
Preoperative medication given before anesthesia

Anesthesiologists may prescribe or administer a premedication prior to administration of a general anesthetic. Anesthetic premedication may consist of a drug or combination of drugs that improve the effects of the anesthetic drugs or prevent side effects and complications. Medications may be given before anesthesia for many reasons, in order to achieve:

  • Reduction of dental anxiety and fear. It is better that the patient is already in a relaxed state before starting the general anesthesia. Most commonly used medications include benzodiazepines such as diazepam, lorazepam, and midazolam which also cause a degree of amnesia.
  • Pain relief. Analgesics may be given to patients who are in pain before the procedure.
  • Reduction of secretions. Anticholinergic drugs may be used to reduce secretions in the mouth and respiratory tract.
  • Reduction in the volume and acidity of gastric contents. Certain medications may be given for reducing the volume and acidity of fluids in the stomach to help reduce the risk of aspiration during GA.
  • Prevention of postoperative nausea and vomiting. Antiemetics may be administered preoperatively to reduce nausea and vomiting.
  • Other. Other medicines may be given to help maintain heartbeat or blood pressure at a stable and regular level.
next page -> The General Anesthesia Procedure

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