General anaesthesia for periodontal surgery

A technique is described in which full-mouth periodontal surgery is carried out under general anaesthesia. The use of an endotracheal tube with inflatable cuff allows good visibility and access to all parts of the mouth unhampered by a throat pack; access is further improved by sloping the operating table foot-down. A system of haemorrhage control is used involving a combination of procedures: smooth anaesthetic induction and controlled carbon dioxide levels; intravenous injection of a fibrinolytic inhibitor (epsilon amino-caproic acid); foot-down tilt to the operating table and infiltration with local analgesic solution. The advantages and disadvantages of the technique are discussed.