I need to have a block bone graft dental procedure. I am afraid to go under sedation.  I already had two procedures without sedation.  I have mild to moderate sleep apnea, and prefer to be awake , with local anesthesia.  I trust my doctor, but not his assistants.  One would not give me an xray shield or thyroid guard for a panoramic xray.  She argued with me, and I gave in reluctantly.   Will not change doctors.  He is reputable, and I am too far invested.  Could I have this done, without sedation ?  I was calm, without sedation through the 1st ptocedure of 3 hours.

I do not know from where your dentist/dental surgeon is obtaining the bone block (i.e. is it autologous or homologous?)  Your concerns are especially justified as even those of us who are board-certified in anesthesiology and do NOT have to concentrate on a dental procedure when sedating one with your history are often "up to our neck in it"  safely managing sedation with sleep apnea!  Implore upon your dentist to do the procedure with a local only; most dentists are quite good at the use of local anesthetics.  If that's not possible,  then would he be willing to do the procedure at a facility with the equipment to safely proceed with a general anesthetic/anesthesiologist present? Does he have an anesthesiologist available to assist him in his office?


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JM Starkman, MD


Over twenty-five years of adult and pediatric, inpatient and outpatient clinical anesthesia practice--some private, some group.

American Association of Physicians and Surgeons. My county medical society.

[not a researcher]

American medical school graduate. Board Certified. Fellowship trained Cardiovascular and Pediatric anesthesia subspecialist.

Past/Present Clients
Over 20,000 anesthetics, the majority of which have been personally managed, with less than 5% consisting of supervising nurse anesthetists or in-training resident physicians.

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