RESUMEN
Background: Cancellation of elective surgery is said to occur when a patient's name appears on the operation list, but the operation is not done on the intended date. Cancelling elective surgeries is a long-standing problem faced by many countries worldwide. Reasons for cancellation of surgery vary from one hospital to another. The goal of this study was to identify factors associated with the cancellation of scheduled Oral and maxillofacial surgeries in the Lagos State University Teaching Hospital. Methodology: Cancellations of elective scheduled operations from January 2021 to July 2022 were reviewed retrospectively. All cancellations were recorded in a predesigned form which included information about the age of the patient, hospital identification number, date of cancellation, type of operation, the Surgeon and the Anaesthetist, preoperative anaesthetic evaluations, any associated medical problems and the presumed reasons for cancellations for in-patients and day case surgery. Patients who died before the time of their scheduled surgery were excluded. Result: 80 patients had their operation cancelled on the day of surgery, and the rate of cancellations was 44.2%. The most common causes of cancellations were patient-related (50%), accounting for up to half of the cancellations. The major reason for cancellation under the administrative category was insufficient time in the theatre to complete the operation list (18.8%). Financial constraint (16.3%) on the day of the surgery was noted more among planned day case procedures and delayed laboratory results (12.5%); oftentimes, covid test results were the major reasons for cancellations under the patient-factors category. Conclusion: The rate of cancellation in this study was high, most of which are patients related. Administrative-related reasons were also identified. However, in most cases, these cancellations can be avoided.
RESUMEN
Background: Procedures in oral surgery, especially surgical extraction of the impacted mandibular third molar is often considered anxiety-producing and stressful. This study evaluated the effect of oral sedation (5 mg diazepam) on the physiological stress level in subjects that underwent surgical extraction of the mandibular third molar by measuring the change in salivary cortisol concentration. Subjects and methods: 204 salivary samples were collected from 102 subjects between 9.00 am and 12.00 pm to standardise the diurnal variations of cortisol secretion. Saliva samples were collected 45 min before and 15 min after surgical extraction from each subject in either group. The samples were stored in the freezer (- 20 °C) until analysis was done in the laboratory using salivary cortisol ELISA kits (DiaMetra S.r.l., Eagle Biosciences, Italy), and the cortisol concentration was measured with a microplate reader. Results: There was a statistically significant change (p = <0.001 between the pre-surgical extraction salivary cortisol concentration of all subjects with a median of 7 ng/ml and post-surgical extraction salivary cortisol concentration of both the study and the control groups with a median of 17 ng/ml and 15 ng/ml, respectively. Only 11.8% of subjects in the study group had a reduction in post-surgical salivary cortisol concentration, while in the control group, 3.9% of subjects had a reduction in post-surgical salivary cortisol concentration. There was no statistically significant difference between the two groups (p = 0.135). Conclusions: Hence, oral sedation has no significant impact on physiological stress during the surgical extraction of the mandibular third molar. However, salivary cortisol concentration can adequately reflect the stress induced by surgical extraction in subjects and its usefulness as a biomarker in stress research. Furthermore, the type of disimpaction of mandibular third molar affects salivary cortisol concentration, with distoangular disimpaction having the highest cortisol concentration and more stressful to subjects when compared to other types of disimpaction.
RESUMEN
BACKGROUND: This paper seeks to investigate the incidence of short-term postoperative complications in children and adult patients undergoing primary surgery of cleft lip and palate. PATIENTS AND METHODS: One hundred and fifteen patients consisting of children (below 12 years) and adult (12 years and above) who were operated for both cleft lip and palate within a 2-year period at the University of Maiduguri Teaching Hospital were reviewed postoperatively at 1 week, 2 weeks, 1 month, 3 months, 6 months, and 1 year intervals, respectively. The complications encountered within the periods of the review were recorded. RESULTS: One hundred and twenty surgeries were performed on 115 patients (85 children 30 Adults). A total of 43 complications (31 in children and 12 in adults) were recorded over the study period. Eighteen (41.9%) of these complications were noticed in unilateral cleft lip repair, while 12 (27.9%) and 13 (30.2%) complications were observed in bilateral cleft lip and cleft palate surgeries, respectively. A higher complication rate (72.0%) was recorded in children compared with adults. Major complications (13.9%) were, however, observed more in adults than children. CONCLUSION: Although every surgeon attempts to prevent complications during surgery, they may still occur. The high complication rate observed in our study may be due to a small sample size. General complications observed among children are due to cross infection during a hospital stay, contributing immensely to the higher rate of complications in children. Moreover, this may be reduced by short hospital stay following surgery. We also advocate early contact with children with cleft, and early surgical intervention in other to prevent some of the major complications encountered in adult patients.
