Patients’ anaesthetic preference
Everyone wants less pain during dental surgery, but it can be challenging for dentists to choose the best drug option for each patient. Dentists have several general anaesthesia alternatives and finding the right option can result in less patient anxiety and better overall outcomes.
Researchers from the Tokyo Dental College in Tokyo, Japan, wanted to find out which anaesthetic was the better choice in a dental office: propofol or sevoflurane. In an article published in Anesthesia Progress, the researchers compared the recovery and satisfaction of 20 patients who had severe anxiety about the dental surgery. All patients were healthy and none had been given general anaesthesia for prior dental treatment.
At two different appointments, each patient was anesthetised with either propofol or sevoflurane alone. Patients were given the same drug to eliminate any movement and a breathing tube was used. The single drug anaesthetic had never been studied; patients were always given opioids or nitrous oxide to keep them anesthetised throughout the procedure, making it difficult to pinpoint the effects of the primary painkilling drugs themselves.
The researchers found no differences between the two drugs in terms of recovery. Although patients came out of anaesthesia more quickly with sevoflurane than with propofol, all patients were discharged at a similar time. A few patients had nausea while recovering from sevoflurane, but none reported complications 24 hours later. All patients were able to eat their first meal and drink fluids at a similar time and no patients experienced nausea or vomiting once leaving the dentists’ office.
However, patients revealed a clear preference for propofol after being anesthetised with each drug. They said they had more discomfort and fatigue after taking sevoflurane. Some also said they disliked the smell of sevoflurane. Even though some patients reported more pain during injection of propofol, 80 percent of patients in the study said they would choose propofol for future surgeries.
The researchers concluded that propofol is the anaesthetic of choice for dental patients with severe anxiety about surgery, but these patients may continue to need general anaesthesia in future surgeries. When patient satisfaction is the highest priority, the researchers suggest that dentists may want to give propofol during in-office surgery.
Full text of the article, ‘Recovery profile and patient satisfaction after ambulatory anesthesia for dental treatment – A crossover comparison between propofol and sevoflurane’, Anesthesia Progress, Vol. 63, No. 4, 2016, is now available at www.anesthesiaprogress.org/doi/full/10.2344/15-00012.1