Doshi M, Shehabi Z, Liu S, Geddis-Regan A General anaesthesia in special care dentistry. Part 1: justifying and planning the use of general anaesthesia. Dent Update. 2024; 51:780-785
King TA, Duffy J Peri-operative care of elective adult surgical patients with a learning disability. Anaesthesia. 2022; 77:674-683 https://doi.org/10.1111/anae.15691
Geddis-Regan AR, Gray D, Buckingham S The use of general anaesthesia in special care dentistry: a clinical guideline from the British Society for Disability and Oral Health. Spec Care Dentist. 2022; 42:(S1)3-32 https://doi.org/10.1111/scd.12652
Cook TM, Lee G, Nolan JP The ProSeal laryngeal mask airway: a review of the literature. Can J Anaesth. 2005; 52:739-760 https://doi.org/10.1007/BF03016565
Goma A, Pons I, Moret ML, Guitart J Satisfaction and complications comparing flexible rein-forced laryngeal mask airways (FRLMA) with ETT in surgery of the face in adults. Eur J Anaesthesiol. 2011; 28
Anderson CR, Premakumar Y, Navaratnam AV The use of throat packs in ear, nose and throat, oral and dental surgery: a systematic review. Rhinology. 2020; 58:306-313 https://doi.org/10.4193/Rhin19.308
Campbell M, Pierce JMT Atmospheric science, anaesthesia, and the environment. BJA Educ. 2015; 15:173-179
Mac Giolla Phadraig C, Fennell-Wells A, Geddis-Regan AR, Wilson K Supporting people and their behaviour in the dental setting as sustainably as reasonably achievable. In: Duane B (ed). Cham: Springer International Publishing; 2022
Bocskai T, Kovács M, Szakács Z Is the bispectral index monitoring protective against postoperative cognitive decline? A systematic review with meta-analysis. PLoS One. 2020; 15 https://doi.org/10.1371/journal.pone.0229018
Ling L, Yang TX, Lee SWK Effect of anaesthesia depth on postoperative delirium and postoperative cognitive dysfunction in high-risk patients: a systematic review and meta-analysis. Cureus. 2022; 14 https://doi.org/10.7759/cureus.30120
Klein AA, Meek T, Allcock E Recommendations for standards of monitoring during anaesthesia and recovery 2021: guideline from the Association of Anaesthetists. Anaesthesia. 2021; 76:1212-1223 https://doi.org/10.1111/anae.15501
Gan TJ, Belani KG, Bergese S Fourth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting. Anesth Analg. 2020; 131:411-448 https://doi.org/10.1213/ANE.0000000000004833
Cook TM, Woodall N, Frerk C Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: anaesthesia. Br J Anaesth. 2011; 106:617-631 https://doi.org/10.1093/bja/aer058
Immediate post-anaesthesia recovery 2013: Association of Anaesthetists of Great Britain and Ireland. Anaesthesia. 2013; 68:288-297 https://doi.org/10.1111/anae.12146
General anaesthesia in special care dentistry. Part 2: delivering dental care Zahra Shehabi Mili Doshi Sophie Liu Andrew Geddis-Regan Dental Update 2025 52:1, 707-709.
Authors
ZahraShehabi
BDS, MFDS, MSc, MSpecCareDent
BDS, MFDS, MSc (Sed Spec Care), MSCD, MSc (Health Management), Consultant in Special Care Dentistry, Bart's Health NHS Trust
BSc (Hons), BChD, DSCD RCS Eng, MSCD RCS Ed, PhD, Consultant in Special Care Dentistry, University Dental Hospital of Manchester; Honorary Senior Lecturer in Dentistry, University of Manchester
The use of general anaesthesia (GA) in dental care needs to be cautiously justified and considered. Preparation for GA can take a considerable degree of planning, especially as the increased prevalence of coexisting systemic diseases in people with disabilities can increase the risks and challenges of care delivery. When a GA has been deemed appropriate and consent has been gained for relevant treatment, providing treatment this way requires further considerations related to anaesthesia and dental care. There is also a recovery period after GA, and there can be additional post-operative considerations. This paper details the ‘how’ of delivering care under GA, including the dental team's role in supporting an anaesthetic team, the delivery of dental procedures, and the logistics of post-GA care.
CPD/Clinical Relevance: The use of general anaesthesia for patients with disabilities and complex needs requires careful consideration and planning.
Article
As detailed in Part 1 of this series, a substantial amount of planning and preparation goes into delivering dental care under general anaesthesia (GA).1 Many of the aspects described below are considered before the day of treatment under GA. However, they are discussed herein as they often present challenges, despite meticulous planning, when care comes to be delivered. Many aspects of this article relate to those individuals with the most significant behavioural or medical requirements for general anaesthesia, such as those with severe learning disabilities, autism and mental health conditions. The nature of dental treatment planning and treatment delivery is detailed briefly, but is not the primary focus of this article.
A range of reasonable adjustments to support patients with additional needs was discussed in Part 1 of this series.1 It is essential that all staff involved in the GA care pathway, including admitting and recovery staff, are aware that the patients have additional needs. The Health and Care Act 2022 introduced a requirement that staff receive learning disability and autism training appropriate to their role, for example, the Oliver McGowan Mandatory Training on Learning Disability and Autism.2
Register now to continue reading
Thank you for visiting Dental Update and reading some of our resources. To read more, please register today. You’ll enjoy the following great benefits: