Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons
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J. Oral Maxillofac. Surg. · Jun 2011
Randomized Controlled TrialA comparison of the effects of midazolam/fentanyl and midazolam/tramadol for conscious intravenous sedation during third molar extraction.
This study evaluated the effects of fentanyl and tramadol, used in combination, as sedation for third molar surgical extraction. ⋯ Tramadol has a better analgesic effect in third molar surgery than fentanyl and placebo.
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J. Oral Maxillofac. Surg. · Jun 2011
Randomized Controlled TrialDoes tranexamic acid in an irrigating fluid reduce intraoperative blood loss in orthognathic surgery? A double-blind, randomized clinical trial.
The aim of this study was to investigate the efficacy of tranexamic acid in an irrigant fluid in decreasing intraoperative blood loss during orthognathic surgery. ⋯ Tranexamic acid in an irrigant fluid does not significantly decrease intraoperative blood loss compared with placebo during orthognathic surgery.
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The purpose of this study was to analyze impalement injuries of the oral cavity in children. ⋯ Most impalement injuries in the oral cavity in children heal spontaneously or with minimal intervention. These children can be followed on an outpatient basis with instructions to their parents about possible complications, except for a few selected cases.
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J. Oral Maxillofac. Surg. · Jun 2011
Case ReportsDexmedetomidine sedation for awake fiberoptic intubation of patients with difficult airways due to severe odontogenic cervicofacial infections.
Odontogenic infections present challenging airway scenarios to surgeons and anesthesiologists. Among specialists, there is controversy over airway management for those patients with airways made difficult by trismus and swelling with anatomic impingement and derangement. Awake fiberoptic intubation has achieved favor in the oral and maxillofacial surgery and anesthesiology communities for management of such difficult airways, but patient comfort and anxiety management with traditional agents may prove hazardous because of potential suppression of protective mechanisms and respiratory depression. ⋯ Dexmedetomidine sedation is advocated for use in awake fiberoptic intubation of patients with cervicofacial infections and difficult airways because of its ability to provide sedation, analgesia, reversible anterograde amnesia, and anxiolysis without impairment of protective reflexes, respiratory depression, or hemodynamic compromise. One of the most significant challenges facing oral and maxillofacial surgeons is the difficult airway. Anatomically compromised airways present unique clinically daunting situations to both surgeon and anesthesiologist, who are both charged with the provision of safe, effective preoperative, intraoperative, and postoperative airway management. Among these conditions, odontogenic infections and patients with head and neck trauma, temporomandibular disorders, orofacial tumors, and severe craniofacial anomalies present for surgical treatment by the oral and maxillofacial surgeon.