RESUMEN
Propofol is a relatively new intravenous anesthetic with qualities that make it useful in the practice of oral and maxillofacial surgery. In a preliminary study to examine the safety of the drug, 100 patients ASA class I patients were treated in an outpatient environment with standardized doses of fentanyl and midazolam in combination with propofol. An induction dose of propofol of 1 mg/kg was followed by a constant bolus given at the rate of 10 mg/minute. The overall quality of induction and maintenance of anesthesia was good to excellent in 91% of cases. The main complications experienced were excessive movements during administration of local anesthesia, movement to stimulation during the operative period, and modest decreases in blood pressure. The results indicate that propofol is an effective means for the provision of general anesthesia in the outpatient oral surgery setting.
Asunto(s)
Procedimientos Quirúrgicos Ambulatorios , Anestesia Dental/métodos , Anestesia General/métodos , Propofol/farmacología , Adolescente , Adulto , Procedimientos Quirúrgicos Ambulatorios/métodos , Periodo de Recuperación de la Anestesia , Presión Sanguínea/efectos de los fármacos , Tos , Femenino , Humanos , Infusiones Intravenosas , Masculino , Persona de Mediana Edad , Tercer Molar/cirugía , Movimiento , Proyectos Piloto , Propofol/administración & dosificación , Estudios Prospectivos , Extracción DentalRESUMEN
A case of serious gastrointestinal bleeding in the postoperative period is reported. A non-steroidal anti-inflammatory drug (NSAID) had been used for analgesia. This case highlights some of the potentially adverse effects of NSAIDs on the GI tract and the risk factors for such effects are discussed.
Asunto(s)
Analgésicos/efectos adversos , Antiinflamatorios no Esteroideos/efectos adversos , Dolor Postoperatorio/tratamiento farmacológico , Úlcera Péptica Hemorrágica/inducido químicamente , Tolmetina/análogos & derivados , Anciano , Carcinoma de Células Escamosas/cirugía , Femenino , Antagonistas de los Receptores H2 de la Histamina/uso terapéutico , Humanos , Ketorolaco , Úlcera Péptica Hemorrágica/tratamiento farmacológico , Sucralfato/uso terapéutico , Tolmetina/efectos adversos , Neoplasias de la Lengua/cirugíaRESUMEN
The complications associated with the use of rigid internal fixation in 31 consecutive patients who had undergone a mandibulotomy for the treatment of pathology of the oral cavity or oropharynx were reviewed. Rigid fixation was accomplished with two major types of systems: compression plates and reconstruction plates. Complications occurred in 11 patients (35%) with an average of 1.7 complications per patient. Most complications were minor in nature, and were treated successfully with conservative measures. Patients who had preoperative radiotherapy were more likely to develop nonunion and osteoradionecrosis. Plate exposure was the single, most common complication, accounting for 13% of the complications. No major differences were noted in the complication rates between the two systems.