Office Based Anesthesia

At The Center for Oral and Maxillofacial Surgery & Implantology your comfort and safety is our most important concern.  Our office is fully equipped to safely provide all levels of anesthesia including general anesthesia, intravenous sedation, as well as conscious sedation with nitrous oxide (laughing gas).  Our facility has been completely inspected and approved by the Washington State Board for administration of these types of anesthesia Dr. Rowshan, and his entire staff have been fully trained in the administration of these types of anesthesia and are confident that your surgery can be done in a comfortable and most importantly, safe manner.

Oral and maxillofacial surgeons are unique among the surgical and dental specialties with regards to anesthesia training. Dr. Rowshan received formal anesthesia training with the Department of Anesthesiology during his residencies in a hospital setting. he demonstrated the skills to safely administer anesthesia to patients and administered hundreds of operating room based anesthesia cases. Our entire staff also have completed and maintained up to date training in Basic Life Support as well as Advanced Cardiac Life Support, in addition to Pediatric Advanced Life Support.

During the initial consultation, the doctor and you and will discuss the type of procedure involved, your medical history and your level of anxiety. Some procedures, due to their nature, require the use of general anesthesia or IV sedation; whereas, others are best accomplished under local anesthesia. The choice of anesthesia is a personal decision between you and your doctor and can only be determined after an informative consultation.  Unfortunately, not every patient is a candidate for every type of anesthesia because of underlying medical and/or physical conditions.  The doctor and staff will do everything to ensure not only your comfort during surgery but equally important, your safety.


I’m going to have general anesthesia, what do I need to know?

Coming to The Center for Oral and Maxillofacial Surgery & Implantology the day of surgery is no different than having surgery in the hospital; however it is much more patient-friendly. The equipment in our surgical suites are similar to those used in the hospitals. When you arrive in the surgical suite the assistant will make sure you are comfortable and will begin to place a blood pressure cuff, an ECG cuff (electrocardiogram) and a pulse oximeter (a device that painlessly measures by using light, both your pulse rate and the amount of oxygen in your blood).  It is suggested that you wear loose clothing to facilitate the application of these important devices.  Every patient who receives anesthesia must have a responsible adult to drive them home after the surgery.

Can I eat or drink before Anesthesia?

Unless you are specifically told otherwise, it is important that you have nothing to eat or drink at least 8 hours prior to the time of your surgery.  Generally this is accomplished by having nothing to eat or drink after Midnight the night before surgery.  This includes drinks of water, coffee and even includes chewing gum!!  If your doctor instructed you to take your daily medications the morning of surgery this should be done with a very small sip of water only.  Please brush your teeth and rinse as usual without swallowing water.

What is General Anesthesia?

General Anesthesia is being completely asleep during the surgery.  If you have this type of anesthesia, we also administer local anesthesia (“numbing medicine”) after you’ve gone to sleep so that when you wake up you will be pain free and comfortable.

What is IV (intravenous) Sedation?

IV Sedation uses similar medications as general anesthesia but the patient is in a “twilight sleep”.  Sedated patients are slightly more aware of their immediate surroundings but are in a much more relaxed state.  Very few patients who receive IV Sedation will remember their surgery at all.  This will be a very relaxing and very sleepy way to have your surgery done.  This often is the technique of choice for patients who may have some underlying medical problems or who will have a short painless procedure.  Even the most anxious patients tolerate this very well.

What is Nitrous Oxide (Laughing Gas)?

Nitrous Oxide Sedation is a method to reduce anxiety.  It is a simple application with a small nose piece placed over your nose.  It reduces anxiety quickly and ends quickly once it is stopped.  Nitrous Oxide does NOT require you to have a driver and it is OK to eat breakfast or lunch.  With this form of anxiety control you are awake, aware and alert but you’ll be a bit more relaxed about the situation.  This also works very well with children.

What is local anesthesia?

This involves administration of an anesthetic solution that numbs or ‘freezes’ a small area. Once the local anesthetic medication has been injected, the area to be worked on is numb, thus allowing the procedure to be performed painlessly. Using local anesthesia only, the patient is completely alert and fully aware of his or her surroundings. Local anesthesia does not decrease the patient’s level of anxiety towards the surgical procedure however it totally alleviates pain.  Many procedures can be done with local anesthesia only with the patient experiencing a totally painless experience.

Are there any special requirements for general anesthesia or IV sedation?

YES. You cannot eat or drink anything no food or liquids for 8 hours prior to the surgery. While  eight hours is suggested as a minimum time of not eating or drinking, each case is evaluated individually. We like you to have fasted from midnight the night prior to surgery and also remind you to bring a responsible driver who can take you home after surgery.

Are there any exceptions to the rule regarding nothing to eat or drink?

YES. Regular medications for heart, blood pressure, seizure disorders, thyroid conditions, ulcers, gastric reflux (GERD), and asthma should absolutely be taken with the smallest amount of fluid that easily permits the pill to be swallowed. This is a discussion your doctor will have with you at your consultation visit.

I use an inhaler for my breathing problems, should I bring it with me?

YES.  Our doctors will discuss with you your frequency of use and likely have you use your inhaler prior to the administration of anesthesia.  Our doctors will also listen to your lungs to determine if your condition is favorable for anesthesia.

I’ve heard stories of people having bad reactions to anesthesia or problems.  Is this true?

At our surgical center we employ only the safest techniques for our patients.  Because of this, we are selective in the type of anesthesia we feel you are qualified to receive.  Our office is equipped with all of the equipment necessary to deal with an emergency should that occur.    Our doctor and staff are highly trained to recognize and treat any problem rapidly.  We routinely use medications that help prevent nausea and pain when awakening from the anesthesia to ensure your comfort long after you have awoken from your procedure.

I have more questions about anesthesia, what should I do?

If you have been scheduled to return to our office for a procedure under any type of anesthesia and have questions, we encourage you to call our office and speak to our highly trained staff.  We are happy to help you understand what your experience will entail before, during and after your surgery.  Call our office at Bellevue Office Phone Number 425-454-5091 with further questions.