Anesthesia for Dental and Oral Maxillofacial Surgery

Spencer D. Wade, DDS, MS is a Clinical Assistant Professor at the New York University College of Dentistry in New York, New York, USA.

Caroline M. Sawicki, DDS, PhD is a Clinical Assistant Professor at the University of North Carolina Adams School of Dentistry in Chapel Hill, North Carolina, USA.

Megann K. Smiley, DMD, MS is in private practice located in Columbus, Ohio, USA.

Michael A. Cuddy, DMD is an Associate Professor at the University of Pittsburgh School of Dental Medicine in Pittsburgh, Pennsylvania, USA.

Steven Vukas, DMD, MD is an Assistant Professor at the University of Pittsburgh School of Dental Medicine in Pittsburgh, Pennsylvania, USA.

Paul J. Schwartz, DMD is an Assistant Professor at the University of Pittsburgh School of Dental Medicine in Pittsburgh, Pennsylvania, USA.

Editorial Board xi

Acknowledgments and Contributors xiii

Preface xiv

Oral/Written Boards xv

Dentist Contributions to Anesthesiology xvii

Glossary of Abbreviations xviii

Section 1 Statistics I Physics I Equipment 1

1.1 Statistics 3

1.2 Anesthetic Monitoring Standards 5

1.3 Pulse Oximetry 6

1.4 Electrocardiography 7

1.5 Blood Pressure Monitors 9

1.6 Temperature Monitoring 11

1.7 Ventilation Monitoring 12

1.8 Capnograms 13

1.9 Fluid and Gas Physics 15

1.10 Medical Gas 16

1.11 Mapleson Circuit 17

1.12 Circle System 18

1.13 Anesthesia Machine Safety Features 19

1.14 Vaporizer 21

1.15 Ventilator 23

1.16 Infusion Pump 24

Section 2 Anatomy I Physiology 25

2.1 Body Fluids 27

2.2 Intravenous Fluids 28

2.3 Head and Neck Blood Supply 29

2.4 Sensory Nerves 30

2.5 Cranial Nerves 31

2.6 Neuromuscular Junction 35

2.7 Parasympathetic Nervous System 36

2.8 Sympathetic Nervous System 37

2.9 Brain 39

2.10 Spinal Cord 41

2.11 Cardiac 42

2.12 Pulmonary 46

2.13 Renal 49

2.14 Hepatic and Biliary 51

2.15 Gastrointestinal 52

2.16 Pancreas 53

2.17 Thyroid 54

2.18 Parathyroid 55

2.19 Adrenal Gland 56

2.20 Vascular 57

2.21 Hematology 58

Section 3 Preoperative Assessment 61

3.1 Psychology 63

3.2 Sedation Levels 64

3.3 ASA Physical Status Classification 65

3.4 Preoperative Cardiac Testing 67

3.5 Preoperative Pulmonary Testing 70

3.6 Preoperative Labs 73

3.7 Airway Evaluation 77

Section 4 Outpatient Medications 81

4.1 Antibiotic Prophylaxis 83

4.2 Smoking 85

4.3 Substance Use Disorder Treatment 86

4.4 Antiplatelets 88

4.5 Anticoagulants 90

4.6 Antihypertensives 92

4.7 Diuretics 94

4.8 Antidysrhythmics 96

4.9 Pulmonary 97

4.10 Non-Insulin Hypoglycemics 99

4.11 Insulin 101

4.12 Antidepressants 103

4.13 Psychiatric 105

4.14 Neurologic 106

4.15 Gastrointestinal 107

4.16 Glucocorticosteroids 108

4.17 Other Medications 109

Section 5 The Perioperative Pharmacology 115

5.1 Inhalational Pharmacokinetics and Pharmacodynamics 117

5.2 Inhalational Agents 120

5.3 Intravenous Pharmacokinetics and Pharmacodynamics 122

5.4 Intravenous Induction Agents 124

5.5 Benzodiazepines 126

5.6 Opioids 128

5.7 Non-opioid IV Analgesics 131

5.8 Neuromuscular Monitoring 133

5.9 Neuromuscular Blocking Agents 135

5.10 Neuromuscular Reversal Agents 137

5.11 Hypertensive Agents 139

5.12 Antihypertensive Agents 142

5.13 Antidysrhythmics 145

Section 6 Adult Disease and Syndromes 153

6.1 Neurologic Disease 155

6.2 Cardiac Disease 160

6.3 Valvular Disease 163

6.4 Bradydysrhythmias 166

6.5 Tachydysrhythmias 168

6.6 Cardiac Conduction Defects 171

6.7 Cardiac Equipment and Transplants 175

6.8 Vascular Disease 179

6.9 Pulmonary Disease 181

6.10 Neuromuscular Disease 183

6.11 Renal Disease 185

6.12 Liver and Biliary Disease 187

6.13 Gastrointestinal Disease 189

6.14 Endocrine Disease 191

6.15 Hematologic Disease 196

6.16 Orthopedic Disease 199

6.17 Immune Disease 201

6.18 Connective Tissue Disease 204

Section 7 Pediatric Disease and Syndromes 211

7.1 Pediatric Anatomy and Physiology 213

7.2 Neonatal/Newborn Disorders 215

7.3 Congenital Heart Defects 224

7.4 Childhood Disorders 228

7.5 Syndromes 236

Section 8 Perioperative Emergencies and Urgencies 245

8.1 Cardiac 248

8.2 Respiratory 248

8.3 Neuro 248

8.4 Metabolic 248

8.5 Other 248

Section 9 Dental Specifics 279

9.1 Common Drug Dosing 281

9.2 Local Anesthetics 283

9.3 Topical Local Anesthetics 286

9.4 Vasoconstrictors 287

9.5 Local Anesthesia for the Trigeminal Nerve (CN V) 288

9.6 Natural Guarded Airway (NGA) 290

9.7 Noninvasive Oxygen Delivery Systems 292

9.8 Airway Adjuncts 294

9.9 Supraglottic Airways 296

9.10 Endotracheal Tubes 298

9.11 Laryngoscopy 300

9.12 Fiberoptic Intubation (FOI) 302

9.13 Submental Intubation 304

9.14 Deliberate Hypotensive Anesthesia 305

9.15 Legal Considerations 306

Section 10 Oral Maxillofacial Surgery 309

10.1 Odontogenic Infections 311

10.2 Orthognathic Surgery 313

10.3 Obstructive Sleep Apnea 315

10.4 Oral Reconstruction 318

10.5 Temporomandibular Joint Disorders 320

10.6 Trauma 322

10.7 Cricothyrotomy 326

10.8 Tracheostomy 327

10.9 Facial Plastic Surgery 328

Index 331