Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Clinical
  • Published:

A guide to general anaesthesia

BDJ Student (2025)Cite this article

Abstract

General anaesthesia (GA) is an essential option for delivery of dental treatment, particularly amongst certain patient groups, such as young children or the very anxious. In fact, dental treatment is one of the most common reasons for a general anaesthetic in children, meaning the general dental practitioner (GDP) is highly likely to encounter patients requiring treatment under GA. It is therefore vital that all dentists (not just those treating patients under GA) are aware of the processes involved, including the relevant risks, to ensure patients are properly informed when they are referred for treatment. This is particularly so, as the referring dentist may be the first port of call for any patient queries.

This is a preview of subscription content, access via your institution

Access options

References

  1. Committee on Quality Management and Departmental Administration. Continuum of depth of sedation: definition of general anesthesia and levels of sedation/analgesia. American Society of Anesthesiologists. 2024. Available at https://www.asahq.org/standards-and-practice-parameters/statement-on-continuum-of-depth-of-sedation-definition-of-general-anesthesia-and-levels-of-sedation-analgesia (accessed 8 October 2025)

  2. Dookun R, Lyne J P, Robb N D. Nitrous Oxide past, present and future. SAAD Digest 1997; 14: 13–35.

  3. Laird W R E. The Yankee dodge: some new observations on the discovery of anaesthesia. Br Dent J 1990; 169: 217–219.

  4. Chang C Y, Goldstein E, Agarwal N, Swan K G. Ether in the developing world: rethinking an abandoned agent. BMC Anesthesiol 2015; 15: 149.

  5. Healy T E J and Un E N. The Mancunian way. Anaesth 1992; 47: 882-886.

  6. A conscious decision, a review of the use of general anaesthesia and conscious sedation in primary dental care London: Department of Health 2000.

  7. Public Health England. Hospital tooth Extractions of 0 to 19 year olds. 2021. Available: https://www.gov.uk/government/publications/hospital-tooth-extractions-of-0-to-19-year-olds (accessed October 2025).

  8. Roizen M F, Foss J F, Fischer S P. Preoperative evaluation. Anesthesia. 5th Edition. Philadelphia: Churchill-Livingstone; 2000. pp. 824–883.

  9. Routine preoperative tests for elective surgery NICE guideline Published: 5 April 2016.

  10. NICE Perioperative care in adults NICE guideline [NG180] Published: 19 August 2020.

  11. Smith G, D'Cruz J R, Rondeau B, Goldman J. General Anaesthesia for Surgeons. StatPearls 2024. Available at https://www.ncbi.nlm.nih.gov/books/NBK493199/ (accessed 9 October 2025).

  12. Committee on Economics. Statement on ASA Physical Status Classification System. American Society of Anaesthesiologists. 2020. Accessed at https://www.asahq.org/standards-and-practice-parameters/statement-on-asa-physical-status-classification-system (accessed 8 October 2025).

  13. Heikal S, Stuart G. Anxiolytic premedication for children. BJA Educ 2020; 20: e220-e225.

  14. Nishina K, Mikawa K, Maekawa N, Tamada M and Obara H. Omeprazole reduces preoperative gastric fluid acidity and volume in children. Can J Anaesth 1994; 41: 925–929.

  15. Selby I R, Bowles B J. Analgesia for venous cannulation: a comparison of EMLA (5 minutes application), lignocaine, ethyl chloride, and nothing. J R Soc Med 1995; 88: 264-267.

  16. Klein A A, Meek T, Allcock E et al. Recommendations for standards of monitoring during anaesthesia and recovery 2021. Anaesth 2021; 76: 1212-1223.

  17. Azam Danish M. Preoxygenation and Anesthesia: A Detailed Review. Cureus 2021; 13: e13240.

  18. Behar J, Bromley L. Anaesthesia: Induction and maintenance of general anaesthesia. BMJ 2007; 334: 070256.

  19. Goetz S, Pritts B, Cornelius B. Sugammadex: Efficacy and Practicality in the Dental Office. Anesth Prog 2018; 65: 113-118.

  20. Sellers C, Woodman N. Inhalation induction in paediatric anaesthesia. BJA Educ 2023; 23: 32-38.

  21. Fang L, Hixson R, Shelton C. Sustainability in anaesthesia and critical care: beyond carbon. BJA Educ 2022; 22: 456-465.

  22. Prince J, Goertzen C, Zanjir M, Wong M, Azarpazhooh A. Airway Complications in Intubated Versus Laryngeal Mask Airway-Managed Dentistry: A Meta-Analysis. Anaesth Prog 2021; 68:193-205.

  23. Quinn A, Samaan A, McAteer M, Moss E, Vucevic M. The reinforced laryngeal mask airway for dento-alveolar surgery. BJA 1996; 77:185-88.

  24. Adewale L. Anaesthesia for paediatric dentistry. Cont Educ Anaesth Critical Care Pain 2012; 12: 288-294.

  25. Nimmo A F, Absalom A R, Bagshaw O, et al. Guidelines for the safe practice of total intravenous anaesthesia (TIVA): Joint Guidelines from the Association of Anaesthetists and the Society for Intravenous Anaesthesia. Anaesth 2019; 74: 211-224.

  26. Cascella M, Bimonte S, Di Napoli R. Delayed Emergence from Anesthesia: What We Know and How We Act. Local Reg Anesth 2020; 5: 195-206.

  27. Jakobsson J G. Recovery and discharge criteria after ambulatory anesthesia: can we improve them? Curr Opin Anaesthesiol 2019; 32: 698-702.

  28. Bailey C R, Ahuja M, Bartholomew K, et al. Guidelines for day-case surgery 2019: Guidelines from the Association of Anaesthetists and the British Association of Day Surgery. Anaesth 2019; 74: 778-792.

  29. RCOA. Common events and risks in anaesthesia. 2019. Available at https://rcoa.ac.uk/sites/default/files/documents/2019-09/Risk-infographics_2019web.pdf (Accessed 8 October 2025).

  30. Shaikh S I, Nagarekha D, Hegade G, Marutheesh M. Postoperative nausea and vomiting: A simple yet complex problem. Anaesth Essays Res 2016; 10: 388-396.

  31. McHardy F E, Chung F. Postoperative sore throat: cause, prevention and treatment. Anaesthesia 1999; 54: 444-453.

  32. Bullard T L, Cobb K, Flynn D N. Intraoperative and Anaesthesia Awareness. StatPearls. 2023. Available at: https://www.ncbi.nlm.nih.gov/books/NBK582138/ (accessed 8 October 2025).

  33. Jenkins K, Baker A B. Consent and anaesthetic risk. Anaesth 2003; 58: 962–984.

  34. van der Griend B F, Lister N, McKenzie I, et al. Postoperative mortality in children after 101,885 anaesthetics at a tertiary paediatric hospital. Anaesth Analg 2011; 112: 1440–1447.

  35. Geddis-Regan A R, Gray D, Buckingham S, Misra U, Boyle C. British Society for Disability and Oral Health. The use of general anaesthesia in special care dentistry: A clinical guideline from the British Society for Disability and Oral Health. Spec Care Dent 2022; 42: 3-32.

  36. British Society of Paediatric Dentistry. Guidelines for the management of children referred for dental extractions under general anaesthesia. 2011 Available at https://www.bspd.co.uk/Portals/0/Public/Files/Guidelines/Main%20Dental%20Guidelines.pdf (Accessed 8 October 2025).

  37. General Dental Council. Standards for the dental team. 2013. Available at: www.gdc-uk.org/professionals/standards (accessed 8 October 2025).

Download references

Author information

Authors and Affiliations

  1. The University of Warwick, Coventry, United Kingdom

    Andrew Swansbury

  2. University Hospital Coventry and Warwickshire, Coventry, United Kingdom

    Charles Pairaudeau

Authors
  1. Andrew Swansbury
    View author publications

    Search author on:PubMed Google Scholar

  2. Charles Pairaudeau
    View author publications

    Search author on:PubMed Google Scholar

Corresponding author

Correspondence to Andrew Swansbury.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Swansbury, A., Pairaudeau, C. A guide to general anaesthesia. BDJ Student (2025). https://doi.org/10.1038/s41406-025-1572-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Version of record:

  • DOI: https://doi.org/10.1038/s41406-025-1572-2

Search

Advanced search

Quick links