Clinical efficacy of regional anesthesia in deeply sedated patients undergoing third molar surgery

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