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. · Dec 2014
Randomized Controlled Trial Comparative StudyEvaluation of the advantageous anesthetic properties of dexmedetomidine used as hypotensive agent compared with nitroglycerin in orthognathic surgery.
To evaluate the advantageous anesthetic properties, such as the decrease of intraoperative analgesic requirement, time to extubation and recovery, and early postoperative pain, of dexmedetomidine used as hypotensive agent compared with nitroglycerin in orthognathic surgery. ⋯ Dexmedetomidine, used as a hypotensive drug, has anesthetic benefits compared with nitroglycerin. Dexmedetomidine decreases the intraoperative fentanyl requirement and does not meaningfully change the time to extubation, early postoperative pain, and analgesic drug requirement.
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J. Oral Maxillofac. Surg. · Dec 2014
Comparative StudyComparison of narcotic prescribing habits and other methods of pain control by oral and maxillofacial surgeons in the United States and Canada.
A previous study of the narcotic prescribing habits and other methods of pain control used by American oral and maxillofacial surgeons (OMSs) after the removal of impacted third molars showed that they often prescribe more tablets of a narcotic than may be necessary. It has been suggested that the excess tablets could be diverted for nonmedical use. The purpose of this study was to determine whether Canadian OMSs have similar narcotic prescribing habits, because Canada has the second highest oral consumption of prescription oral narcotics in the world. ⋯ The use of codeine plus an NSAID by Canadian OMSs for managing pain after the removal of impacted third molars rather than the more addictive drug hydrocodone raises the question of whether the latter drug is being overprescribed in the United States.
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J. Oral Maxillofac. Surg. · Dec 2014
Use of human recombinant bone morphogenetic protein is associated with increased hospital charges in children with cleft lip and palate having bone graft procedures.
There is wide variation in the timing of secondary alveolar bone grafting in patients with cleft lip and palate. The objective of the present study was to examine the timing and hospitalization outcomes of bone grafting procedures in a cohort of 5- to 13-year-old patients with a diagnosis of cleft lip and palate. ⋯ Bone grafting procedures are safe when performed in patients 5 to 13 years old. Insertion of rhBMP was performed in nearly 1% of patients undergoing bone grafting procedures. Use of rhBMP was associated with a considerable increase in hospital charges.
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J. Oral Maxillofac. Surg. · Dec 2014
Postoperative delirium in head and neck cancer patients: a survey of oncologic oral and maxillofacial surgeon practices.
Effective delirium risk management for head and neck surgical patients has not been investigated. The present study was undertaken to determine oncologic oral and maxillofacial surgeons' postoperative delirium diagnostic and management practices. ⋯ The present study highlights distinct variations in the medical management of postoperative delirium, with most surgeons prescribing medications that have been shown to potentiate or exacerbate delirium or have not been proved to have superior therapeutic benefit. Haloperidol remains the first-line drug of choice in the management of patients appropriately diagnosed with postoperative delirium. Prospective investigations for risk stratification and postoperative delirium are needed.
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J. Oral Maxillofac. Surg. · Nov 2014
Randomized Controlled TrialAre muscle relaxants needed for nasal intubation in propofol and remifentanil anesthesia?
The authors hypothesized that a muscle relaxant would have no meaningful difference in intubation conditions during nasal intubation under remifentanil and propofol anesthesia. ⋯ Muscle relaxants during nasal intubation performed after bolus administration of propofol 0.9 mg/kg in addition to 10 minutes of remifentanil 0.5 μg/kg per minute plus propofol 5 mg/kg per hour are unnecessary.