GENERAL ANESTHESIA FOR DENTAL SURGERY IN INCREASED RISK CASES

p I S account describes a method of general anaesthesia X which has proved very useful in those increased risk cases requiring dental surgery, who are unsuited to local or regional anaesthesia by reason of oral sepsis, of wide-spread caries, or of temperament. Such are some with neglected mouths needing attention as part of the treat-ment of bronchiectasis, myocarditis or nephritis, chronic cases such as disseminated sclerosis, and antenatal cases who are late in seeking oral hygiene. The risks in mind are not only those to life, but also liability to post anaesthetic complications and to relapse or increase of disease. PREPARATION For these people it has been found wise to use the theatre table rather than the dental chair, in order to favour cerebral circulation in the feeble and to allow the anaesthetist better access during the induction. The supine position makes necessary very full precautions against the inhalation of dental fragments or vomitus, which are more easily con-trolled when cases are seated. Fragments are kept away from the glottis by packing the throat; but empty stomachs must be ensured by admission of patients at least four hours before the extractions, and by giving intravenous glucose when diabetics require a substi-tute for lunch