General Anaesthetic and General Anaesthesia Germany
General anaesthetic treatments at Berlin Klinik
Specifically at the BERLIN-KLINIK International Hospital and Dental Clinic, we offer patients tested and successful concepts for full dental and implantological restoration or surgical interventions in full anaesthesia: "Sleep – wake up – done!" This usually permits painless and stress-free, as well as time-saving performance of many unpleasant appointments that may cause anxiety or have been rescheduled often in a single treatment under anaesthesia.
General anaesthetic dental restoration
Treatment under anaesthesia down to complete restoration of the jaws, gums and teeth, with or without implants, are performed as routine treatments in the BERLIN KLINIK International Hospital and Dental Clinic. We comprehensively plan every little detail and combine many long and sometimes unpleasant and stressful tooth treatments in a single treatment under anaesthesia.
General anaesthetic for cosmetic surgery
Treatment under anaesthesia for wellness surgery and aesthetic-plastic surgery. Almost all aesthetic-plastic surgeries, such as facelift procedures of different techniques or all breast enhancement procedures are offered under general anaesthetic at BERLIN KLINIK International Hospital and Dental Clinic as well.
Anaesthesia for oral and maxillofacial surgery
General anaesthetic for performance of all oral and maxillofacial surgeries, including those performed on the nose and ears, are, of course, also offered under general anaesthetic at BERLIN KLINIK International Hospital and Dental Clinic.
Anaesthetist Berlin Klinik
A scientific description of anaesthesia is "pharmacologically induced, reversible coma." Artificial anaesthesia therefore causes a temporary, reversible functional inhibition of the central nervous system, causing loss of consciousness, sleep and deactivation of perception of pain (analgesia). In many cases, flaccid paralysis of the controlled muscles is desired as well. Anaesthesia also causes reduction of reflexes. Anaesthesia is part of anaesthesiology, which is performed routinely at BERLIN-KLINIK International Hospital and Dental Clinic by specialists with special further training: Specialist physician for anaesthesiology and intensive care, anaesthetist.
General anaesthetic for internatonal patients
Like all medical processes, anaesthesia requires active contribution not only from the physician, but also from the patient! The patient cooperates with the anaesthetist for his safety. In particular for out-patient treatment under anaesthesia, the medical team requires the patient's cooperation. Before surgery the patient learns everything that is important about the upcoming anaesthesia and his stay at BERLIN KLINIK from the anaesthetist and receives answers to his questions. The physician assesses the possibility of using anaesthesia and the anaesthesia risk. Together with the patient, the best anaesthesia procedure (general anaesthesia, regional anaesthesia or a combination of the two) is selected. The patient is informed in detail of the risks of the anaesthesia procedure sand signs an informed consent. Because of the pre-medication prescribed during this meeting, the pre-surgery doctor's visit is also called pre-medication meeting.
Anaesthesia medication and obligations Germany
The current recommendations on medication to be taken in the context of surgery and anaesthesia/regional anaesthesia are complex. In this context, medication effects, co-morbidities, the type of surgery and anaesthesia/regional anaesthesia must be considered. This particularly refers to medication for hypertension/arterial hypertension, antidiabetics and substances that influence blood clotting. Therefore, the procedure may have to be coordinated with the treating physician and the anaesthetist before the surgery. These medical productions are available in a liquid, dissolved form. They must be injected. The highly popular and very well compatible product Propofol, for example, is well compatible even for longer anaesthesia and poses a low strain on the body. Absorption and elimination of an injection narcotic are generally different from those of inhalation narcotics. While the gases are mainly supplied to and removed from the organism by breathing, injection narcotics are supplied by injection and eliminated by metabolisation in the liver or elimination through the kidneys. The intraoperative monitoring measures for Germany are stipulated in the medical products act (Medizinproduktegesetz) and the medical device operator ordinance (Medizingerätebetreiberverordnung). Both laws implement the European standard EN 740. The recommendation of the Deutsche Gesellschaft für Anästhesie und Intensivmedizin DGAI on monitoring anaesthesia and equipping anaesthesia workplaces is used as a standard.
General anaesthetic and General anaesthesia in Berlin
These are the reasons for fasting before surgery: General anaesthetic anaesthesia temporarily switches off the patient's consciousness in a controlled fashion. This includes failure of important protective reflexes, such as the inhalation reflex, gag reflex, cough reflex. The cough reflex usually serves to free the trachea of foreign bodies or contamination. To avoid aspiration, i.e. entering of stomach contents into the breathing tract, it is important for the stomach to be empty. In case of regional anaesthesia, complications may occur that require intubation and subsequent general anaesthetic. For planned surgeries, the patient therefore has to fast even if regional anaesthetic is used. For emergency surgery, not having an empty stomach may be an argument for preferring regional procedures to keep the danger of aspiration low.
General anaesthetic procedure in Berlin
At the BERLIN-KLINIK Zahnklinik, balanced anaesthesia with injection narcotics and the very gentle, well compatible TIVA total intravenous anaesthesia using only injected anaesthetics are usually used. In these, a soporific like Propofol is combined with an analgesic like Fentanyl. This combination can be controlled relatively well. No gas is used. Except of the seldom use of laughing gas anaesthesia. At BERLIN-KLINIK, where general anaesthesia is regularly used, patients can look at the anaesthesia workplaces within the surgery areas if they wish. In practices where anaesthesia is used rarely, a "mobile anaesthetist" will bring in a mobile workplace.
FAQ general anaesthetic for dental treatment
What is the difference between local anaesthetic and general anaesthetic?
Answer: A local anaesthetic is injected close to the nerves (e.g. Articain, Lidocain, Procain, Novocain...) at the body or in the mouth, so that they no longer forward any pain. This permits pain-free surgery of the affected part of the body. General anaesthetic uses narcotics to induce unconsciousness. Such substances can be injected into the veins (e.g. Propofol, Ketamine) or inhaled as a gas (e.g. nitrous oxide or Halothane). In addition to inducing unconsciousness, pain killers and muscle relaxants are administrated as well. We at BERLIN-KLINIK usually use TIVA general anaesthetic and the very well compatible medication Propofol.
Who is responsible for general anaesthetic at BERLIN KLINIK?
Answer: The anaesthetist, a specialist for anaesthesia and emergency medicine, is responsible for keeping the patient in an artificially induced sleep during surgery and to remove his muscle reflexes. He is responsible for the overall condition of the patient during surgery and the time after surgery. The anaesthetist is not only responsible for preparation and performance of anaesthesia during surgery, but also monitors and ventilates the patient after the surgery on the ward and in intensive care, as well as dealing with pain therapy. Anaesthetists are responsible for ensuring the vital functions of breathing and cardiac activity.
Who can be treated under general anaesthetic at BERLIN-KLINIK?
Answer: Generally, any healthy person can be treated under general anaesthetic. There is hardly any age limit for it anymore. General anaesthetic can be used just as well in a two-year old child as in an eighty-year-old adult. The anaesthetist will decide from case to case, according to condition and constitution, whether or not anaesthesia is possible. We specialise in therapy for adults, but we are able to treat children as well. Treatment under general anaesthetic permits unpleasant, complicated or very comprehensive surgery and therapy at best efficiency for therapy scope / time.
How will I be monitored during general anaesthesia at BERLIN KLINIK?
Answer: The following of the patient's body functions are monitored continually: ECG, recording of the heart's electrical activity, by a monitoring device for continuous observation of the patient's cardiac activity. The blood oxygen content is also continually monitored. For this, a pulse oxymeter with a sensor is attached to the patient's finger. Blood oxygen content is also continually registered to continually adjust the concentration and mixture of the anaesthetics. For this, a small bracket with a sensor is attached to the patient's finger. The patient's blood pressure is measured with a collar on his arm or by a probe in the wrist artery. For larger surgeries, the blood pressure can also be measured right at the heart. This is performed by a catheter that is pushed through a vein at the neck or below the clavicle until it nearly reaches the heart.
How will the anaesthetic be administered at BERLIN-KLINIK?
Answer: To initiate general anaesthesia, a quick-acting soporific is injected into the patient's vein. The most frequently used anaesthesia is called TIVA Total Intravenous Anaesthesia. The medication used is Propofol. During surgery, various medications must be injected into the blood stream through a cannula with vein access. It is usually applied at the back of the hand.
Who performs anaesthesia and general anaesthesia at BERLIN-KLINK?
Answer: Local anaesthesia is usually performed by the surgeon himself. For more comprehensive types of anaesthesia, analgo sedation or general anaesthesia, the anaesthetist, specialist for anaesthesia and emergency medicine at BERLIN-KLINIK, is responsible. He is supported by specialised nurses and regular nurses, who will assist him before, during and after surgery.
Which examinations are required before anaesthesia?
Answer: The anaesthetist must be informed in detail about the physical condition of his patient before any surgery. There is a premedication interview for this. Only this information enables him to select the correct type of anaesthesia. Possibly required preliminary examinations include recording of the heart current curve (ECG), a thoracic X-ray (heart and lung) and blood examination (haemoglobin, potassium, sodium, coagulation factor, creatinine, urea and liver values); a lung-function test may also be required. The examinations are determined by the number and type of existing diseases and the surgery's requirements. The patient must not suffer from any acute sickness like cold, flu, cough, etc. After such sickness, surgery should not be performed for at least two weeks. In case of chronic diseases of the heart, lungs, blood, liver, thyroid gland or lungs, your attending physician must approve the anaesthesia! In this case, the patient must inform his or her general practitioner.
Will the anaesthetist inform the patient of the type and risks of anaesthesia?
Answer: Of course. Before surgery, the anaesthetist will discuss everything that may be important for anaesthesia based on the anaesthesia questionnaire the patient completed. In particular, existing diseases, earlier surgery and possible facts and results that may lead to anaesthesia problems are inquired about. The anaesthetist will also inform the patient of the different possibilities of anaesthesia and support him in his decision. The anaesthetist does, however, depend on focussed and honest cooperation by the patient.
Why is it forbidden to eat or drink for eight hours before surgery?
Answer: During general anaesthetic, the entire tension of the body's muscles is removed by muscle relaxants. This measure is required to permit the surgeon to work easily. At the same time, this means that the muscles of the gastrointestinal tract are relaxed. This leads to the danger of stomach content flowing back into the oesophagus and from there getting into the trachea and the lungs. This would be a potentially fatal complication! Therefore, you must not eat or drink within eight hours before your elective anaesthesia. In case of emergency surgery, the stomach is emptied with a probe or emptying is inhibited by medication.
What medication must be taken before surgery under general anaesthetic?
Answer: The anaesthetist and your general practitioner will decide together whether you may/should continue to take medication you previously took regularly due to your doctor's prescription or voluntarily. The patient is obliged to inform the anaesthetist as precisely a possible of EVERYTHING he has taken, if possible in writing. The anaesthetist specifies the previous medication / medication to be taken before the surgery or what medication is to be used to prepare you for surgery.
Do I have to expect adverse effects or any complications during surgery?
Answer: Of course. Just as you need to expect to be injured or die when crossing a road, disaster is possible during ANY medical intervention! Frequent adverse effects of various anaesthesia methods are nausea, vomiting, sore throat or temporary numbness of anaesthetized or strained body regions. Usually, they are unpleasant for patients, but relatively harmless and will pass without any consequences. The anaesthetist tries to avoid them and also knows how to alleviate these symptoms if required. Other complications like allergic shock, metabolic decompensation or cardiac arrest are unpredictable adverse effects.
Will I surely wake up again after anaesthesia?
Answer: When the surgery is completed, anaesthesia will be ended by no longer adding any anaesthetic. The anaesthetist will inject medication that revokes the anaesthesia effect and removes the muscle relaxation. The patient will wake up in the surgical theatre and be taken to the ward room in the bed or a wheelchair, where his bed is waiting for him. However, the patient will be sleepy for some time longer, depending on constitution, intensity and duration of anaesthesia. All important bodily functions need to be monitored uninterrupted for some time longer on the ward and the organism must be supplied with all necessary substances and medication intravenously.
Will I need to vomit after anaesthesia?
Answer: The older ether or chloroform anaesthesia methods had vomiting as a near-typical part of anaesthesia. State-of-the-art anaesthesia gases and venous anaesthetics that are injected are much less of a strain on the organism, so that post-surgical vomiting occurs rarely or never. If the patient is nauseous after waking from anaesthesia anyway, this condition is treated with medication.
Does general anaesthetic at BERLIN-KLINIK also have adverse effects that may harm me?
Answer: Just like any medication, anaesthetics may also have adverse effects. They need to be degraded by the liver, for example, which may cause problems if the liver is already damaged. Very. very rare allergic reactions may also occur. If there is an allergic shock during anaesthesia, an allergologist must systematically find out the substance that may have triggered the allergy after surgery. This is vital for later surgeries.
Is it possible to go home after general anaesthetic at BERLIN-KLINIK?
Answer: Generally yes. Outpatient anaesthesia requires that there is a person available to take the patient home and present close to the patient's residence. Driving is forbidden, but going home by public transport on your own is not allowed either. If the patient starts to feel unwell at home, she or he must be able to call help. A controlled and monitored stay at the BERLIN-KLINIK ward is usually safer for you.
Are costs for dental treatment under anaesthesia assumed by the health insurance?
Answer: The costs for anaesthesia are only assumed by the health insurance in case of certain rare indications. Indications are currently patients with mental disabilities, children under 12 years who will not permit treatment otherwise, and patients who do not tolerate dentist's local anaesthetics or who are allergic to them, and in whom this has been documented by a specialist. In individual cases, excessive gag reflex in the scope of dental treatment may be accepted as an exception that warrants general anaesthesia. However, this must be reviewed from case to case and approved by health insurance in writing. Private insurance will only assume costs for general anaesthetic if they are justified and contractually agreed on.
What is the difference between sedation by the dentist and anaesthesia at BERLIN-KLINIK?
Answer: Analgo sedation means that you do not sleep! You will be awake and responsive, but the medication will cause deep relaxation to the point of retrograde amnesia. You will still be able to perceive pain, so that the dentist must inject local anaesthetic. Sedation is only permitted if monitored by an anaesthetist because the medication administered may lead to respiratory depression. Breathing on your own may be a problem during dental treatment and there is the definite danger of inhaling something, which is a very severe complication. During general anaesthetic, you are deeply asleep. Pain perception is completely gone due to the medication and additional local anaesthesia is not absolutely required. Treatment may take up to several hours if required. You will not be able to swallow or inhale anything.
Are fear or phobia of the dentist a disease?
Answer: Dentist phobia is defined as a disease (ICD 10, 40.2, an anxiety disorder). Among others, fear causes you to more or less lose focus and control of your rationally controlled action, the pulse frequency rises and motor skills reduce as well as the ability to think rationally. You may lose control of your bowels or bladder. Among others, measurable biochemical processes will occur. All in all, this is a condition in which rational behaviours or decisions are not possible, or only with limitation. Sedatives will not help or help only little. A person suffering from dentist phobia has a disease and requires medical help.
What makes a "Specialist for dentist phobia"?
Answer: Some say: emotional intelligence, special communicative skills and the ability to cooperate. In bitter reality of the advertising outward presentation, it's more like: unscrupulous business skills, hypocrisy and moderate quality of dental treatment as such. Fear is and has always been something some people have "specialised" in to make great business. They use fear and lack of information for their own benefit. It is particularly negative if these self-proclaimed "specialists for dental phobia" claim that other dentists are unable to treat patients suffering from dentist phobia with the aid of an anaesthetist.
What is a "Specialist for dentist phobia"?
Answer: There are certainly laudable exceptions. However. advertising with this "specialisation" means a dentist who had little success in patients who are awake and mature. Dentists who have only achieved medium-quality and little representative success may have turned to the much more lucrative sleeping fear patients at some point. They can perform very comprehensive treatments that are often far too expensive as compared to the quality of the dental medicine provided. It is worst in those cases where dentists specialising in treatment of dentist phobia patients are commercially organised on a commercial-organisational level.