Surgical Instructions

Dr. Flugrad

Before IV Sedation:

1. Do not eat or drink anything for six (6) hours prior to the appointment, including water.

2. A responsible adult must accompany you to the office, remain in the office during the procedure, and drive you home.

3. Please wear comfortable clothing with sleeves that can be rolled up past the elbow and low-heeled shoes.

4. Please do not wear contact lenses, jewelry, or nail polish on the day of surgery.

5. If you take any medication daily (blood pressure medicine, fluid pills, etc.) continue to take these medications in your regular dosage unless otherwise instructed by Dr. Flugrad. You may take sips of water to swallow these pills.

6. If you have an illness such as a cold, sore throat, stomach or bowel upset, please notify the office.

7. If you use any tobacco products you will have a significantly increased chance of post-operative complications, including extended discomfort and dry sockets. We strongly advise you to discontinue these habits during your healing phase.

8. You may want to have a pillow in the car for a more comfortable ride home.

9. It will be helpful for you to have ice packs ready at home for postoperative swelling.

10. You should not drive a vehicle or operate any machinery for 24 hours following anesthesia.

11. If you have any questions at all, please call the office at which your surgery is scheduled.


As an oral and maxillofacial surgeon, I have special training in outpatient anesthesia.
Anesthesia as an outpatient in our office can vary from vocal local to true general anesthesia.

1. Vocal Local – Local anesthesia is used to numb the surgical sight. You can bring in your own CD’s or tapes that can be played for your comfort or you can listen to my poor jokes or my incessant conversation on just about anything (from the Doors to the Jets to my kids!)

2. Nitrous oxide – oxygen (laughing gas) – This is one modality of anesthesia that we use in the office. It is not general anesthesia but rather relaxes you to allow the procedure to be done within your comfort zone.

3. Intravenous sedation – This is a type of anesthesia in which most patients are extremely relaxed for the procedure. As the patient, you are usually amnesiac for the procedure, i.e., you do not remember the procedure. However, you are never totally asleep and can be easily arousable. This is the type of anesthesia that is most used in our office.

4. Deep sedation – This type of anesthesia requires more medication and a few more precautions. With this procedure, you might lapse into general anesthesia for a few seconds to a few minutes. However, you are easily arousable and it is very safe.

5. General anesthesia – This is the most difficult anesthetic technique to use as an outpatient. It is used for extremely fast procedures and only on patients that have no medical problems. Many procedures in our office can be done with this technique.

Some of our procedures can be done with oral pre-medication such as Valium a short time before your surgery. As with any of our surgical techniques, a thorough examination is performed before surgery. Vital signs (blood pressure, heart rate and respiratory rate) will be monitored on all patients. If deeper anesthetic techniques are required and EKG (electrocardiogram) might be taken and pulse oximeter used during the surgery. Before any sedation technique is used, a heart-lung examination will be performed by myself.

In preparation for your surgery, I suggest that you wear loose, comfortable clothing with sleeves that can be easily rolled up. You should arrange for a responsible adult to accompany you to your surgery and be able to drive you home afterward. You may be drowsy for a while after anesthesia and driving is unsafe. It is very important that before any intravenous sedation is administered, that you do not drink or eat for 6 hours before surgery. However, new anesthesia guidelines allow you to drink clear liquids up to two hours before surgery. Clear liquids are anything you can see through (water, apple juice). Milk is not a clear liquid, neither is coffee.

Please – it is important to discuss with me and my office staff any special requirements or needs that you have prior to your surgery and anesthesia.

Please – inform us of any medical problems or changes in your medical history.

Above all – please ask me any questions you might have during your consultation visit and/or prior to your surgery and anesthesia. Our office policy is to make every patient as happy as possible; this can only be done if you ask me any questions you might have.

Oral & Maxilofacial



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