general anaesthesia
General Anaesthetic procedures are performed at St Andrews Hospital, Spring Hill, Upper Mt Gravatt, or Chermside facilities.
Following your initial visit, treatment can be provided under local anaesthesia, Happy Gas or General Anaesthetic. General Anaesthetics can be done at a private hospital or in-house theatres at Spring Hill, Chermside, and Upper Mount Gravatt practices. We have a fully equipped outpatient anaesthetic theatre for children needing to be treated under general anaesthesia. Specialist medical anaesthetists attend our practice and are supported by experienced anaesthetic nurses.
WHAT ARE THE EFFECTS OF A GENERAL ANAESTHETIC?
After a general anaesthetic your child may feel disorientated and also uncomfortable. Occasionally, he or she may become agitated and perhaps have a tantrum. These are all normal reactions, which will wear off given a bit of time, usually in the first half hour. They may also feel dizzy and drowsy and complain of nausea, vomiting and a sore throat.
HOW SAFE IF THE GENERAL ANAESTHETIC?
We treat approximately ten cases under general anaesthetic in our rooms each week. Our selected panel of specialist anaesthetists are rostered to come into our rooms to provide anaesthetics. We have the best record and being the longest practice in Brisbane providing general anaesthetics in our practice for the last twenty years with no major complications.
HOW LONG WILL IT TAKE TO RECOVER AFTER THE GENERAL ANAESTHETIC?
After the procedure, your child is placed in our recovery room. We prefer that patients stay for at least half an hour to recover. It is best to wait until your child reaches home to have something to eat or drink. We advise against drinking or eating, before the trip home or in the car as the associated nausea from the general anaesthetic can cause patients to throw up. Your child should be able to resume normal activities (e.g. school) after 24 hours. If there are any complications please call our anaesthetist, who will advise you on the necessary actions to take.
HOW MUCH WILL IT COST?
The cost of the general anaesthetic and dental treatment will depend on the amount of work that needs to be done and the time required completing the treatment. During the consultation the dental work, estimated costs and other options will be discussed.
WHEN IS PAYMENT REQUIRED?
A deposit is required when a booking is made for the general anaesthetics. The balance payment must be settled on the day of treatment. Generally, you are able to claim about 40% of the anaesthetic bill back from Medicare.
WHAT HAPPENS AFTER THE GENERAL ANAESTHETIC?
If there are any concerns or problems, please do not hesitate to contact the surgery. A review visit can be arrange usually a month from treatment.
To maintain good dental health, it is then recommended that your child see their family dentist every six months for a check-up. If you do not have a family dentist, we are more than happy to see you here or recommend a dentist close to home.
PROCEDURE TO FOLLOW FOR GENERAL ANAESTHETIC DENTAL APPOINTMENTS
1. General Anaesthetic procedures are performed at St Andrews Hospital, Spring Hill, Upper Mt Gravatt or Chermside facilities.
2. Please confirm your appointment with us the day before your general anaesthetic. If confirmation is not done, your appointment may be given to another patient.
3. Please inform us as soon as possible if your child develops symptoms of a cold such as a runny nose or cough, before your general anaesthetic appointment.
BEFORE GENERAL ANAESTHETIC SURGERY:
a) Your child must NOT eat for seven (7) hours before general anaesthesia and surgery. This includes solids, foods, milk and non-see-through liquids.
b) Your child must NOT drink within three (3) hours before general anaesthesia and surgery. Only water can be given up until three (3) hours before the time of surgery.
c) Panadol and Nurofen and will be given to your child when you arrive. Occasionally, sedative will be given in cases of extremely nervous patient after discussion with the anaesthetist. Please keep them seated once they have had the sedative.
d) It is important that your child is comfortable during surgery. Therefore, please ensure that your child wears loose comfortable clothing. It is a good idea to bring a change of clothes. For individual with long hair, please have the hair tie up into two pigtails.
e) Please arrive 1 hour before your scheduled appointment for examination by the anaesthetic in the room or arrive 2 hours for pre-admission procedure at St Andrew’s Hospital.
PRE-MEDICATION
In aiming to reduce the anxiety (only when absolutely necessary) and to allow our patients to cope better with the general anaesthetic, patients maybe pre-medicated with midazolam (a sedative), after discussion with parents. Once this has been swallowed by your child, parents are instructed to have the child seated with you as they become quite drowsy and will surely fall or injure themselves if the parents do not hold on to the child. Otherwise routinely, only paracetamol syrup and nurofen will be given to patients one hour before the procedure.
AFTER GENERAL ANAESTHETIC SURGERY:
a) Please ensure that there are two people to take your childhome after surgery
b) Avoid other accompanying children (too distracting)
c) Private transport (Private car or Taxi). If a private car is used a second adult will be required to take care of your child whilst the other is driving.
d) Have water, Paracetamol or Nurofen available for long journey (greater than 1 hour)
e) Avoid having any other appointments or commitments prior to getting your childhome (give your child undivided attention)
PAYMENT OF ACCOUNTS:
a) We require a deposit to book the surgery. The deposit can be paid by Mastercard, Visacard, Bank Transfer or Bpay
b) Both the dental and anaesthetic accounts must be settled in full on the day of treatment. Payment may be made by cash, Eftpos, Mastercard, Visacard or Bankcard but NOT with personal cheques or AMEX.
c) A refund for part of these accounts is obtainable from Medicare for the anaesthetic costs and your private health fund for the dental specialist treatment.
AFTER HOURS CONTACT
While we aim to provide you with the best care available, our practice is only limited to treatment during working hours. If your child has just undergone general anaesthetic surgery, we provide you with the number of our specialist paediatric Anaesthetist should any concerns arise.
If you have an afterhours concern, please send an email to buzz@kidsdental.com.au
GENERAL ANAESTHESIA FOR YOUR CHILD
PROCEDURES
A number of different methods may be used to anaesthetize your child. The method below is by far the most commonly used. If a different method is to be used this will be discussed and described to you prior to the procedure beginning.
1. Half an hour before the anaesthetic is expected to start your child will be given a small volume of Panadol and Nurofen syrup to drink.
Panadol and Nurofen lessens discomfort on awakening. In cases where sedative is administered, the patient may become wobbly on their legs, so we ask you to keep a watchful eye. The sedative is a low dose to help the child be more accepting of the procedure. Very occasionally a child may become uninhibited and hyperactive from it. Your child should also be escorted to the toilet to empty his/her bladder immediately after taking the premedication before the premedication takes effect (usually 10-15 mins).
2. When we are ready to begin the procedure, your child is brought to the dental chair, or operating table if in a hospital. Parents are welcome to be present as the child goes to sleep to provide moral support for your child and we ask you to hide your own anxiety if possible. Most children go to sleep by breathing a smelly air. Our anaesthetic gases have improved markedly over recent years and most children accept the mask and gas with little protest especially if parents try the mask on first. Over 10-15 breaths the child goes off to sleep. Most children frequently move around during this process. Children will have strange breathing sounds whilst going to sleep. Please do not be concerned.
3. When your child is under anaesthetics, we request parents to relax in the waiting room. Alternatively, parents could go for a walk or have something to eat if you have been starving as well. Leave your phone turned on.
4. The anaesthetist places a breathing tube, usually through a nostril into the windpipe (this may result in a bloody nostril after the procedure). Additionally, a small intravenous tube, usually in the hand, will be introduced, to give anaesthetic drugs and a sterile saline solution, a ‘drip’, to keep your child well hydrated, (more importantly in Brisbane’s hotter months). The specialist paediatric dentist will then begin the procedure. Your child is fully monitored and your anaesthetist remains with your child throughout the procedure.
5. When the specialist paediatric dentist has finished the procedure the anaesthetic drugs are stopped and your child gradually awakens. The child is then transferred to the recovery bed. At this stage you will be asked in to be with your child. Depending on your child’s rate of awakening you may leave 45 minutes to 2 hours after the end of the procedure.
POSSIBLE COMPLICATIONS OF THE ANAESTHETIC PROCEDURE
Serious complications are fortunately very rare. Death due to anaesthetic would occur about once in every 150000 cases. If any, of the following complications are noted please follow the instructions given.
A) Vomiting
Prolonged vomiting is most uncommon with the technique we use.
In the most unlikely event, your child is persistently vomiting 8 hours after leaving Dr. P.Y.’s room we suggest that you take your child to seek medical attention, either your G.P. or a hospital casualty. This will particularly apply in the hottest months. In cold weather you could wait a few hours longer as our need for fluids to remain well-hydrated is less.
B) Serious Breathing Problems
A serious breathing problem after leaving Dr.P.Y’s would be extremely unlikely.
In the event that your child was appearing to struggle for breath we would suggest that you either immediately take your child to a Casualty or call an ambulance urgently, depending on your proximity to a Casualty.
C) Allergic Reaction
An allergic reaction would normally be apparent before your child leaves Dr.P.Y’s rooms.
More information is available about the risks and complications associated with general anaesthesia. This information can be found at www.anzca.edu.au/patients/frequently-asked-questions/risks
HOSPITAL OR IN OUR ROOMS
Should your child have his or her dental treatment requiring general anaesthesia at Dr.P.Y’s rooms in Spring Hill, Upper Mt Gravatt, and Chermside or in a hospital?
A) Rooms
The main advantage to treatment in Spring Hill, Upper Mt Gravatt or Chermside is that children and adults may find hospitals more intimidating. However, we have a weight limit of 50kg for treatment in rooms.
Dr P.Y.’s rooms have the full range of appropriate equipment and the anaesthetists are qualified specialist using the safest technique. In the last 20 years, anaesthetics had been given in this practice without any major complications. It is always possible to transfer the child to the hospital if necessary.
Another advantage to treatment in Rooms is financial, for those without private insurance.
B) Hospital Advantages
If your child has a significant medical condition, for example severe asthma, a heart condition or severe obesity, then we would prefer to treat your child at a hospital.
A hospital has the advantage of more staff and an intensive care facility in the extremely rare event of your child having a major complication.
In some cases, the assistance of a St Andrews accredited Physician or Paediatrician maybe required if the patient requires an overnight stay for prolonged vomiting. This may bare extra cost if required.
HOSPITAL ADMISSION FOR PATIENT WITH COMPLEX MEDICAL HISTORY OR SPECIAL NEEDS
Before admission to St Andrews War Memorial Hospital
It is essential you must complete the St Andrew's Hospital admission online at www.standrewshospital.com.au and click on 'book my admission'.
Patients with special needs, disability, or medical condition to contact our specialist anaesthetist and St Andrew's Hospital nurse for confirmation. (Please call our office on 3831 5677 for details).
Any patients needing to take anticonvulsant medications - (must take 1 teaspoon of yoghurt with medication before leaving home prior to the hospital admission).
Please provide the hospital for all your specific requirements for example special needs patient needing a hoist or a private room if they are disruptive and other needs including medications on 07 3834 4444.
Assistance of Physician or Paediatrician
In some cases the assistance of a St Andrews accredited Physician or Paediatrician maybe required before and after the patients procedure. This may bare extra cost if required.
Review Visits
If there are any concerns or problems, please do not hesitate to contact the surgery. A review visit can be arranged usually a month from treatment. To maintain good dental health, it is then recommended that the patient see their family dentist, every six months for a check-up. If you do not have a family dentist, we are more than happy to see you here or recommend a dentist close to home.