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. · Feb 1994
Randomized Controlled Trial Comparative Study Clinical TrialPatient-controlled analgesia: a comparison of dosing regimens for acute postsurgical pain.
This study compares several dosing regimens for patient-controlled analgesia (PCA) in the management of acute maxillofacial surgical pain. The dosing methods differed by presence or absence of an active drug (morphine [MS] vs saline), presence of a baseline infusion, and dose of drug delivered. Sixty-eight patients were enrolled in this prospective, randomized, double-blind, placebo-controlled trial that lasted 24 hours. ⋯ This study calls into question the usefulness of PCA with MS in maxillofacial surgery patients. Pain control was questionable at best, and the rate of emesis was unacceptably high in patients with potentially compromised airways. Further research is required to determine if other analgesics provide better pain control with less nausea in the PCA system or if antiemetics can effectively be used to lower the incidence of nausea and vomiting.
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J. Oral Maxillofac. Surg. · Aug 1993
Comparative StudyOutcomes after same-day oral surgery: a review of 1,180 cases at a major teaching hospital.
Outcome was measured from data collected on 1,180 consecutive ambulatory oral surgery patients, two thirds of whom were treated under general anesthesia and the remainder who were treated under local anesthesia supplemented with intravenous sedation. Three patients (0.25%) required admission on the day of surgery; all had undergone general anesthesia. The surgery-related complication rate in the general anesthesia group (1:132) was similar to that for local anesthesia and sedation (1:128). ⋯ At the time of follow-up during the first few postoperative days, 7% of patients had gone to a family doctor and 4% to hospital accident and emergency departments, usually for minor problems. Paracetamol 500 mg plus codeine phosphate 30 mg was effective in 97% of cases when provided as a take-home analgesic. Ninety-nine percent of patients were satisfied with their management.