Summary
Introduction:
This text provides an in-depth analysis of the implications of electronic cigarettes on the safe administration of sedation and general anesthesia in the outpatient dental setting. It highlights the dangers of electronic cigarettes, which are often perceived as safer alternatives to conventional cigarettes, and the impact they have on systemic and oral health. The article also discusses the special considerations for sedation and anesthesia providers treating patients who use electronic cigarettes.
Key Points:
* Electronic cigarettes, also known as vaping devices, were originally introduced as aids for smoking cessation but have become increasingly popular as users perceive them as safer alternatives to conventional cigarettes.
* Recent studies have shown that electronic cigarettes are not safe and can have adverse effects on systemic and oral health, similar to combustible tobacco products.
* Electronic cigarettes contain a heating element that vaporizes a liquid solution, often containing nicotine, which the user inhales.
* The vapor produced by electronic cigarettes contains harmful chemicals, such as heavy metals, carcinogens, and mutagens, which can have detrimental effects on the periodontium of the oral cavity, increasing the risk of periodontitis, tooth loss, and dental implant failures.
* The use of electronic cigarettes has been linked to male erectile dysfunction, which is thought to be caused by impaired vasodilation and reduced penile circulation due to the elevated nicotine levels found in vaping aerosols.
* Prolonged exposure to diacetyl, diketone, and 2,3-pentanedione, which are commonly found in e-liquids, can lead to fixed airflow obstruction, gas exchange impairment, and obstructive lung disease.
* The fine particulate matter produced by electronic cigarette devices can create a pro-inflammatory state within bronchial and alveolar cell lines, leading to increased generation of reactive oxygen species and triggering apoptosis and programmed necrosis in pulmonary cell lines.
* Providers should be aware of the acute and chronic systemic effects of electronic cigarette device use to aid in preventing, identifying, and managing adverse events, particularly airway obstruction, which is the most common and concerning adverse event.
Main Message:
The text emphasizes the importance of understanding the dangers of electronic cigarettes and the impact they have on systemic and oral health. Sedation and anesthesia providers should take a thorough history during their preoperative assessment, inquiring about the frequency of e-cigarette use, when the patient last used their device, and what substances they inhale using their device. This information will help providers prevent, identify, and manage adverse events related to electronic cigarette use, ensuring patient safety during the perioperative period.
Citation
heller Za, Ms ECa, Dmd JEP. Implications of Electronic Cigarettes on the Safe administration of Sedation and General anesthesia in the Outpatient Dental Setting. anesthesia progress. 2022;69(2):41-52. doi:10.2344/anpr-69-02-16
