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 2015
Randomized Controlled Trial Comparative StudyA randomized trial to identify the most effective dose of remifentanil during Le Fort I osteotomy.
The Le Fort I osteotomy (L-I) requires extensive dissection and manipulation of tissue, causing hemodynamic instability and an undesirable postoperative stress response. This study aimed to clarify the most effective dose of remifentanil during L-I. ⋯ Remifentanil administration at 0.75 μg/kg/minute stabilized hemodynamics during L-I without major side effects. Results indicated that the standard index of remifentanil administration during L-I should be 0.75 μg/kg/minute when using oxygen, propofol, and remifentanil for general anesthesia.
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J. Oral Maxillofac. Surg. · Jun 2015
Randomized Controlled Trial Comparative StudyEffect of dexmedetomidine on preventing agitation and delirium after microvascular free flap surgery: a randomized, double-blind, control study.
To determine whether dexmedetomidine sedation in the postanesthesia care unit (PACU) could decrease agitation and delirium after free flap surgery. ⋯ Dexmedetomidine does not change the overall incidence of agitation after free flap surgery; however, it does decrease agitation after PACU admission. It does not prevent delirium within 5 days postoperatively.
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J. Oral Maxillofac. Surg. · Jun 2015
Randomized Controlled Trial Comparative StudyA randomized clinical trial of the effects of submucosal dexamethasone after surgery for mandibular fractures.
To evaluate the effects of immediate postoperative submucosal dexamethasone administration on postoperative pain, edema, trismus, and mandibular functions after open reduction and internal fixation (ORIF) for mandibular fractures. ⋯ The results of our study suggest that submucosal administration of dexamethasone after ORIF for mandibular fractures is effective in reducing postoperative pain and edema.
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J. Oral Maxillofac. Surg. · Jun 2015
Randomized Controlled Trial Comparative StudyA nasal high-flow system prevents hypoxia in dental patients under intravenous sedation.
Hypoxia is a major complication in dental patients under intravenous sedation (IVS). A nasal high-flow (NHF) system has been reported to achieve effective oxygenation in patients with sleep apnea syndrome. This study investigated the ability of the NHF system to prevent hypoxia in dental patients under IVS. ⋯ These results suggest that use of the NHF system can prevent hypoxia in dental patients under IVS. Further studies are necessary to determine the appropriate flow rate and indications for NHF in obese patients.
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J. Oral Maxillofac. Surg. · Jun 2015
How does the close surgical margin impact recurrence and survival when treating oral squamous cell carcinoma?
The surgical margin is the main prognostic factor over which the surgeon has control during resection of oral squamous cell carcinoma (OSCC). This study examined the association between surgical excision margins of patients with OSCC and outcomes of disease-free and overall survival. ⋯ The results suggest that the presence of a close surgical margin (1 to 5 mm) is an adverse risk feature comparable to an involved margin and therefore is associated with decreased disease-free and overall survival. Future studies are needed to replicate these findings before they can be used as a basis for clinical recommendations.