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. · Apr 2011
Randomized Controlled Trial Comparative StudyEffects of midazolam/low-dose ketamine conscious intravenous sedation on pain, swelling, and trismus after surgical extraction of third molars.
To assess the clinical efficacy of midazolam plus low-dose ketamine conscious intravenous sedation on relief from or prevention of postoperative pain, swelling, and trismus after the surgical extraction of third molars. ⋯ Conscious intravenous sedation with midazolam/low-dose ketamine during surgical extraction of third molars can provide the patient with a comfortable procedure and good postoperative analgesia, with less swelling and significantly less trismus. Intravenous low-dose ketamine may be safe and effective in reducing postoperative pain.
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J. Oral Maxillofac. Surg. · Apr 2011
Comparative StudyOptimal degree of mouth opening for laryngeal mask airway function during oral surgery.
This study was performed to determine the optimal degree of mouth opening in anesthetized patients requiring laryngeal mask airway (LMA) during oral surgery. ⋯ This study showed that a mouth opening over 4 cm led to substantial increases in oropharyngeal leak pressure and intracuff pressure of the LMA, warranting caution, because gastric insufflation, sore throat, and ventilation difficulties may occur. A mouth opening of 3 cm achieves acceptable airway conditions for anesthetized patients requiring LMA.
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J. Oral Maxillofac. Surg. · Mar 2011
Administration of general anesthesia for outpatient orthognathic surgical procedures.
The administration of anesthesia has shifted away from the traditional hospital setting to an enormous increase in the use of outpatient facilities. The development of short-acting anesthetics, advances in surgical techniques, and paradigm shifts accepting targeted hospital admission and preoperative testing have allowed the acceptance of outpatient anesthesia for a wide variety of surgical procedures, including orthognathic procedures. ⋯ The administration of anesthesia for orthognathic surgery in an outpatient setting requires preoperative preparation, preoperative patient assessment and selection, use of short-acting anesthetic agents and techniques, presence of emergency drugs and equipment, appropriate recovery protocols and staff, and the presence of adequate caregivers upon home discharge. Anesthetic techniques and agents allowing multiple orthognathic procedures to be performed in the outpatient setting are described.