Expert: JM Starkman, MD - 5/19/2009

Question
my mother in law lives in mexico. she suffers from hbp. she had a stroke and has limited mobility on her right side. she is needing dental work and had an abnormal pap at the age of 49. she was told that they need to do a procedure where they scrape sample from uterus, I guess, but was told she could not have anesthesia because of her hbp condition. when she wants to do dental work they have told her also that she can't have any anesthesia and she needs alot of work done. only because she is scared to go. It would be to painful she says. I want to get her some help and need some options.  thank you for your time.

Susana

Answer
Anesthesiologists personally(as opposed to dentists, gynecologists and surgeons) regularly deal with preoperative medical conditions that must be optimized prior to anesthesia/surgery.  Irrespective of whether or not 'some other doctor' has "cleared" or "not cleared" a patient for surgery the anesthesiologist will know how to evaluate and safely anesthetize someone who MUST have a certain surgery or procedure done (e.g. abcessed tooth, appendectomy, cancer diagnosis).  Have an ANESTHESIOLOGIST evaluate her, categorize her risk factors, optimize them. None of the procedures you mention involve a great degree of what we call 'physiologic trespass' i.e. a great 'assault' on one's body.  They all may be augmented by a degree of local anesthesia which can minimize anesthesia exposure and, presumably, risk.

If the dentist or surgeon in question doesn't know an anesthesiologist for a referral, get a new dentist or surgeon.