1. Survey of Dental Outpatient Anaesthesia Practice (DOPA) in Scotland

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

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

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

7. 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.

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

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

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

13. 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

14. Models
Dundee dental clinic
RHSC Edinburgh

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

16. Airway Techniques

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