ABSTRACT
The hypothesis of this study was to determine if the severity of post - operative pain following minor to moderate oral surgeries would affect patients' health -related quality of life in the immediate postoperative period. This study was designed as a prospective, non randomized observational trial in the department of Oral and Maxillofacial surgery in the Faculty of Oral and Dental Medicine, Cairo University. Patients subjected to this study underwent oral cysts enucliation or multiple wisdom teeth extractions under general anesthesia. Patients received standardized general anesthesia and intra-operative analgesia. Visual analogue scores and a form multiple questionnaires, or short form -12 [SF-12] for assessing pain at rest and on activity, nausea and itching were evaluated on postoperative days 1-2 and 3. The severity of pain correlated with a decrease in both the physical and mental components of the short form. The severity of nausea correlated with a decrease in the mental but not the physical component of the short form. The severity of itching did not correlate with a change in the short form. Our findings suggest that an increase in the immediate post - operative pain will decrease the quality of patient's life
ABSTRACT
The purpose of this study was to assess the safety and efficacy of a new technique using regional anesthesia under deep level of sedation. Extraction of forty wisdom teeth (forty patients) was performed under the effect of two different anesthetic techniques. Proprofol 2.5 mg/Kg B.Wt. was administered in order to facilitate laryngeal mask insertion. Patients were classified into two main groups; group A [n=20] received 45% of the estimated Minimal Alveolar Concentration [MAO Halothane, while group B [n=20] received 25% of the estimated MAC Halothane. All patients received nitrous oxide-enriched Oxygen. Extractions in group B were performed using additional Xylocaine Hcl 2% as an anesthetic agent in a deeply sedated patient [deep level of sedation MAC 25% Halothane]. Pre, intra and post-operative data were recorded for all and patients were asked to grade the post-operative pain on scale of 0 [no pain] to 10 [unbearable pain]. The surgeon was blind for the groupings. This technique did not interfere with surgery. The incidence of patients who required additive intravenous or inhalation anesthetic is zero percent. In group A, preoperative and intra-operative cardiovascular and respiratory parameters showed statistically significant differences while in-group B, the differences were statistically insignificant. No significant differences were found between both groups as regards postoperative pain. The incidence of nausea was significantly higher for group A patients, [p=0.02] There were no reported incidences of nausea and vomiting in group B patients. No cases of aspiration or postoperative dysphagia were recorded during the study. The Vcchmqxie anesthesiabased deep eve of sedation is safe and highly effective especially in apprehensive, uncooperative, mentally retarded and claustrophobic patients. The short recovery times and the zero percentage of Postoperative Nausea and Vomiting [PONV], make this technique suitable for day case surgeries. The use of 25% MAC [Halothane] is very close to the MAC -awake. Since the technique of kinetic Dentoalveolar surgery needs specially trained surgeons, and due to the inevitable necessity of Jens and iris manipulation in dense Dentoalveolar procedures, the proposed technique is recommended as the most suitable for certain groups of patients and surgeons who prefer to perform Dentoalveolar surgery in the immobilized , unconscious patients. This study is an approach for further evaluation and research in the subject of deep sedation
ABSTRACT
In patients with myofascial pain, painful trigger points are often treated using local anaesthetics and/or steroids injections. However, the therapeutic effects of these treatment have not been quantified, and the mechanism underlying the effect is poorly understood. In a randomized clinical trial, thirty adult patients of both sexes and of an age range of 17-42 years were treated for myofascial pain in the jaws. They had presented with myofascial pain that could be traced back to trigger points in the masseter and/or the temporalis muscles. The trigger point number and distribution was mapped prior to the commencement of any treatment form. The treatment results were analyzed after a series of local anaesthetic [xylocaine] injections only of the trigger points [group A], steroid [epidron] injections only [group B] and combined injection therapy [xylocaine + epidron] [group C. Data used for evaluation and statistical analysis included 1- number of trigger points before and after treatment sessions. 2- changes in pain measuring or visual analogue scale and 3-changes in maximal interincisal distance values. Electromyographic readings were used to monitor responses to different kinds of treatment. The results show group C patients to favour a significant and remarkable drop in the median number of trigger points after two weeks of therapy. Likewise, visual analogue scale ratings for group C patients decreased significantly after the second and third weeks of treatment. As for maximal interincisal distance values, they were markedly increased after the third week of treatment in the same group of patients