Survey of Dental Outpatient Anaesthesia Practice (DOPA) in Scotland

Reasons for Survey Compare practice across Scotland Highlight deficiencies in Dundee dental outpatient service

Publications Royal College of Anaesthetists. Standards and guidelines for general Anaesthesia for Dentistry. 1999. Macmillan C, Wildsmith JAW. A survey of paediatric dental anaesthesia in Scotland. Anaesthesia 2000; 55: 581-6

Survey of ‘SPAN’ members 39 members: 18 sites: 16 replies Email survey of SPAN membership Questions about ‘process of dental outpatient anaesthesia care’

Results: Personnel Anaesthetic assistance always provided by trained anaesthetic nurse / ODP Recovery: in all units provided by recovery nursing staff (or anaesthetic nurses) in a separate recovery area.

Results: Preoperative Ametop / EMLA for IV induction option: 12 / 16 units Fasting times: 14 / 16 used 2hrs fluid fast

Results: intraoperative Analgesia Opioid analgesia available:10 / 16 units Wide variety of analgesia techniques Airway management

Standards of perioperative care 12 of 16 respondents felt that standards of care were equivalent to those for inpatient and day case surgical patients

Conclusions Personnel are appropriate Level of monitoring is appropriate Standard of IV induction available for 70% of children Analgesia varies widely Discharge times 7 centres discharge times <1hr 14 centres discharge times < 2hrs

Models Dundee dental clinic RHSC Edinburgh

Analgesia for DOPA As many techniques as units Mix of Preop, intraop and postop paracetamol, NSAID, opioids and Local anaesthesia Edinburgh audit

Airway Techniques

Questions Should care match other areas? SPAN have a role? Optimum analgesia: audit Techniques of airway management