The British journal of oral & maxillofacial surgery
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Br J Oral Maxillofac Surg · Apr 2000
Randomized Controlled Trial Clinical TrialBehavioural measurement of postoperative pain after oral surgery.
The amount and type of postoperative analgesia prescribed depends on the clinician's judgement of the patient's need. Among other factors, this judgement is likely to be based on the patient's behaviour. ⋯ The results also show differences between the sexes in their reaction to pain. Significantly more women than men showed signs of pain, despite little difference in self-rating pain scores.
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Br J Oral Maxillofac Surg · Apr 2000
Management of anticoagulation in patients with prosthetic heart valves undergoing oral and maxillofacial operations.
There is wide variation in the management of patients with mechanical prosthetic valves who are taking anticoagulants and who require non-cardiac surgery. In this paper, we outline a pragmatic, practical approach to the adjustment of anticoagulation in relation to both the degrees of surgical trauma during oral and maxillofacial surgery and the risk of thromboembolism associated with the prosthetic valve. ⋯ For major surgery, warfarin is stopped preoperatively and low-molecular-weight heparin is used. For emergency surgery, partial reversal of anticoagulation with low-dose parenteral vitamin K is obtained.
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Br J Oral Maxillofac Surg · Oct 1999
Randomized Controlled Trial Comparative Study Clinical TrialUse of intra-articular morphine for postoperative analgesia following TMJ arthroscopy.
Recent studies have suggested that giving opioids locally into inflamed tissue may cause analgesia. This antinociceptive effect has been attributed to the interaction of the drug with opioid receptors upregulated by inflammation in the peripheral tissues. ⋯ Twenty-one patients took part in a randomized controlled double-blind trial and received one of these three solutions at the end of operation. The pain scores, time to the first request for analgesia, and the analgesic consumption of the patients in the three groups did not differ significantly at any time during the study period.