Pre-Operative Assessment

Introduction

A common encounter in pediatric offices include the pre-op "clearances". For example, patients may be referred from dental offices to assess if a patient can undergo sedation for a dental extraction. The real question the referring dentist is asking you is - Is this patient safe to undergo the effects of anesthesia?

The American Society of Anesthesiologists offer recommendations for sedation and anesthesia services in dental office-based settings. Specifically, they recommend:

For dental office-based sedation and/or anesthesia care, the availability and use of appropriate monitors and safety equipment in a manner consistent with current ASA Standards, Statements and Guidelines.
ASA recommends that age-appropriate equipment and medications for use in resuscitation and related emergency care are immediately available. ASA recommends emergency care and transfer processes should be incorporated into the office’s emergency protocols.
A designated individual, other than the individual performing the procedure, should be continuously present to monitor the patient throughout procedures performed with minimal or moderate sedation. During deep sedation and/or general anesthesia, this individual should have no other responsibilities. Some office-based center have rotating anesthesiologists that oversee procedures.

References

https://www.asahq.org/standards-and-practice-parameters/statement-on-sedation--anesthesia-administration-in-dental-officebased-settings