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. · Nov 2014
Introduction of craniomaxillofacial surgery as a component of medical student training in general surgery.
This study provides an overview of the objective structured clinical examination (OSCE) in concept, determination of task difficulty, execution, and evaluation by students and examiners. ⋯ CMS was successfully implemented in the general surgical training for medical students, with an initial PST and a final OSCE concordant with the literature. The CMS implementation effectively trained and fairly evaluated clinical skills. Although an OSCE consumes time and resources, this addition proved feasible and valuable, even with large numbers of students, and students expressed a high level of satisfaction with the training.
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J. Oral Maxillofac. Surg. · Oct 2014
Randomized Controlled Trial Comparative StudyPre-emptive analgesia with pregabalin and celecoxib decreases postsurgical pain following maxillomandibular advancement surgery: a randomized controlled clinical trial.
The purpose of this study was to determine the efficacy of pre-emptive analgesia with pregabalin and celecoxib on narcotic consumption and perceived pain in adult patients undergoing maxillomandibular advancement surgery for obstructive sleep apnea. ⋯ Within the limitations of this study, a 1-time preoperative oral dose of pregabalin and celecoxib before adult maxillomandibular advancement surgery for obstructive sleep apnea decreased mean intravenous morphine consumption, mean daily narcotic pill consumption, and mean patient perceived pain.
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J. Oral Maxillofac. Surg. · Oct 2014
Case Reports Comparative StudyPostoperative gastrointestinal bleeding in orthognathic surgery patients: its estimated prevalence and possible association to known risk factors.
To assess the prevalence of gastrointestinal (GI) bleeding in patients after orthognathic surgery and its relation to known risk factors. ⋯ Postoperative GI bleeding complication is rare in orthognathic surgical patients, with an estimated prevalence of 0.4%. Based on these observations, orthognathic surgical patients who require mechanical ventilation and are receiving anti-inflammatory medications may have an increased risk of GI bleeding. In the absence of active bleeding from the surgical site, persistent decrease in hemoglobin concentration should alert one to consider the possibility of UGIB.
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J. Oral Maxillofac. Surg. · Oct 2014
Case ReportsDexmedetomidine and ketamine sedation for dental extraction in children with cyanotic heart disease.
Treating children with cyanotic congenital heart disease poses many challenges to anesthesiologists because of the multiple problems associated with the condition. The anesthetic technique and drugs used perioperatively can affect a patient's physiologic status during surgery. ⋯ In the present case series, we describe the use of a dexmedetomidine-ketamine combination for dental extraction in spontaneously breathing children with cyanotic congenital heart disease. The anesthetic concerns regarding airway management, the pharmacologic effects of drugs, and maintenance of adequate hemodynamic, blood gases, and acid-base status are discussed.
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J. Oral Maxillofac. Surg. · Sep 2014
Comparative Study Observational StudyContinuous noninvasive hemoglobin measurement is useful in patients undergoing double-jaw surgery.
Continuous measurement of hemoglobin by pulse CO-oximetry (SpHb; Masimo Radical 7 device, Masimo Corp, Irvine, CA) may be helpful during double-jaw surgery when massive hemorrhage is anticipated. Given the possible influence of low blood pressure on the detection of hemoglobin levels, the agreement of the SpHb was evaluated in patients undergoing orthognathic surgery when using hypotensive anesthesia. ⋯ Continuous monitoring of hemoglobin may help to determine the appropriate time to perform an invasive measurement of hemoglobin in patients who undergo double-jaw surgery.