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. · Oct 1987
ReviewUse of cricothyroidostomy in oral and maxillofacial surgery.
Surgical entry into the upper airway is not only important in emergency situations but also in the treatment of certain elective maxillofacial procedures. The procedure of choice by which surgical access is gained has traditionally been a tracheostomy. ⋯ The purpose of this paper is to present the anatomy, indications, and surgical technique of cricothyroidostomy. It is concluded that cricothyroidostomy, and not tracheostomy, is the preferred procedure for surgical establishment of an upper airway, either in elective maxillofacial surgical procedures, or in an emergency situation.
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J. Oral Maxillofac. Surg. · Sep 1987
Case ReportsRhabdomyolysis and acute renal failure following use of succinylcholine and enflurane: report of a case.
A case of succinylcholine and enflurane induced rhabdomyolysis and myoglobinuric acute renal failure in a mentally retarded patient is presented. The report illustrates some principles of management and the correlation of laboratory findings with the syndrome. When using general anesthesia in mentally retarded patients it is recommended that: 1) a careful personal and family past anesthetic history be taken; 2) drugs and apparatus for treatment of the crisis be available before anesthesia is induced; 3) the use of succinylcholine and potent inhalation anesthetic agents be avoided; 4) there is early diagnosis by prompt recognition of the clinical signs; and 5) that body temperature monitoring and frequent observation of vital signs during and after an operation be carried out.
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J. Oral Maxillofac. Surg. · Sep 1987
Case ReportsBilateral fixation of a nasotracheal tube by transfacial Kirschner wires.
Because of the high margin for error with transfacial internal wire fixation, even in the hands of an experienced practitioner, alternative modalities in the treatment of zygomaticomaxillary complex fractures should be considered. When the use of transfacial rigid wire fixation is indicated, emphasis should be placed on prevention and early recognition of nasotracheal transfixation to avoid unnecessary postoperative catastrophies.
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J. Oral Maxillofac. Surg. · Feb 1987
Randomized Controlled Trial Clinical TrialEffect of pretreatment with acetaminophen-propoxyphene for oral surgery pain.
To determine the effect of pretreatment and multiple doses on postsurgical pain, a study of the relative analgesic efficacy of placebo, acetaminophen 650 mg, and propoxyphene napsylate 100 mg alone and in combination was conducted. Forty-five patients undergoing surgical removal of impacted third molar teeth under local anesthesia were randomly allocated to the four treatment regimens under double-blind conditions. The first oral dose was administered one hour preoperatively and the second dose when the pain became moderate or severe, following the dissipation of the local anesthesia. ⋯ Duration of analgesia was also significantly longer with both propoxyphene-containing treatments. No side effects were reported. The results suggest that pretreatment with a narcotic agonist markedly improves postoperative analgesia.