ABSTRACT
Statement of the Problem: Extraction of the impacted third molar is often associat-ed with severe postoperative pains, management of which are a big challenge. Lamotrigine is a new antiepileptic drug with pre-emptive analgesic properties, which is hypothesized to alleviate postoperative pain
Purpose: This study aimed to evaluate the efficacy of pre-operative administration of single oral 200 mg lamotrigine in reducing the postoperative pain of impacted third molar surgery
Materials and Method: In this randomized controlled trial, 100 adult patients were divided into two groups [n= 50] to receive either 200 mg oral lamotrigine or placebo 1 hour before the removal of impacted third molar. The patients were monitored for 4 hours in the recovery room and pain intensity was measured through visual analogue scale [VAS] for the next 12 hours at 30-minute intervals. The time and number of rescue analgesics used in 12 hours was also recorded
Results: Two groups were not statistically significantly different regarding the sever-ity of postoperative pain. [p= 0.512]
Conclusion: Accordingly, pre-emptive administration of lamotrigine was not effec-tive in diminishing the postoperative acute pain of impacted third molar extraction
ABSTRACT
Statement of the Problem: Due to shortage of ICU beds in hospitals, knowing what kind of orthognathic surgery patients more need ICU care after surgery would be important for surgeons and hospitals to prevent unnecessary ICU bed reservation
Purpose: The aim of the present study was to determine what kinds of orthognathic surgery patients would benefit more from ICU care after surgery
Materials and Method: 210 patients who were admitted to Chamran Hospital, Shiraz, for bimaxillary orthognathic surgery [2008-2013] were reviewed based on whether they had been admitted to ICU or maxillofacial surgery ward. Operation time, sex, intraoperative Estimated Blood Loss [EBL], postoperative complications, ICU admission, and unwanted complications resulting from staying in ICU were assessed
Results: Of 210 patients undergoing bimaxillary orthognathic surgery, 59 patients [28.1%] were postoperatively admitted to the ICU and 151 in the maxillofacial ward [71.9%]. There was not statistically significant difference in age and sex between the two groups [p> 0.05]. The groups were significantly different in terms of operation time [p< 0.001]. Blood loss For ICU admitted patients was 600.00 +/- 293.621mL and for those who were hospitalized in the ward was 350.00 +/- 298.397 mL. Statistically significant differences were found between the two groups [p< 0.001]. Moreover, there was a direct linear correlation between operation time and intraoperative estimated blood loss and this relationship was statistically significant [r=0.42, p< 0.001]. Patients with maxillary impaction and setback plus mandibular advancement plus genioplasty were among the most ICU admitted patients [44%], while these patients were only 20% of all patients who were admitted to the ward. As a final point, the result illustrated that patients who were admitted to the ICU experienced more complication such as bleeding, postoperative nausea, and pain [p< 0.001]
Conclusion: Orthognathic surgery patients [maxillary impaction and setback plus mandibular advancement plus genioplasty] due to more intraoperative bleeding and postoperative nausea and pain would benefit from ICU admission after surgery