Mistakes in dental anesthesia administration that can lead to coma identified## Contribution

Unqualified administration of general anesthesia during dental procedures without an anesthesiologist can lead to overdose and severe complications, including death, Dmitry Eremin, Associate Professor and Deputy Director for Medical Work at the Institute of Dentistry of Pirogov University of the Russian Ministry of Health, told "Gazeta.Ru".

In Krasnoyarsk, an anesthesiologist from a dental clinic is accused of the death of a seven-year-old patient. The boy died during dental treatment under general anesthesia. A similar case occurred in the Moscow region: a four-year-old boy died from pulmonary edema during dental procedures under anesthesia at the Odintsovo clinic.

"The choice of anesthesia should correspond to the scope of intervention, the patient's condition, and the presence of comorbidities. Before the appointment, the patient should fill out a 'patient questionnaire' where they report comorbidities and drug intolerances. If a patient undergoes intravenous anesthesia or general anesthesia, it is advisable to order tests (complete blood count, urinalysis), ECG, and an examination before the procedure. The anesthesiologist determines the method of anesthesia and dosage of drugs, coordinating actions with the dentist. During sedation, monitoring of vital signs (heart rate, oxygen saturation, etc.) is necessary. However, not all clinics are equipped with proper equipment, and procedures are sometimes conducted without an anesthesiologist, which increases the risks of possible complications, as in the case of the deceased boys," the doctor explained.

To administer anesthesia, a clinic must have a license, appropriate equipment, and a staff anesthesiologist-resuscitator and other personnel, according to the equipment standard.

"In practice, some institutions save on specialists and equipment, formally complying with requirements. This is dangerous because, in case of complications, the necessary equipment or instruments and specialists may not be available. With an incomplete medical history, even with inhalation anesthesia, severe consequences are possible, including heart failure. The lack of supervision by an anesthesiologist increases the risk of tragedies, especially in children and the elderly. This is a high-risk group," the doctor added.