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At least 19 recordsLinked to original sources
PubMed2003

Minor oral surgical procedures in patients on oral anticoagulants--a controlled study.

BACKGROUND: Patients on therapeutic anticoagulation are at risk of bleeding from minor oral surgical sites. When the anticoagulant regime is modified to prevent the risk of bleeding, this at the same time predisposes the patient to risks of the medical condition for which they are being treated. METHODS: A total of 70 patients who were on warfarin treatment requiring minor oral surgical procedures were treated in the Oral Surgery Department. A control group of 35 had their warfarin stopped prior to the minor oral surgical procedure. The other 35 formed the study group. Patients with an International Normalized Ratio outside the therapeutic range of 2-4, or with history of liver disease or on drugs affecting liver function were excluded from the study. Any incidences of post-operative bleeding were recorded. RESULTS: None of the patients in either control or study group had any serious bleeding complications. CONCLUSION: The data suggest that patients can safely undergo routine minor oral surgical procedures without alterations of their therapeutic anticoagulation regime.

Adult↗
PubMed1995

Fatal intracranial hemorrhage following pediatric oral surgical procedure.

Deaths during dental and oral surgical procedures may lead to litigation alleging malpractice. For this reason, and because of their sudden and unexpected nature, they often come to the attention of forensic pathologists. We review the clinical and anatomic findings of a 3-year-old boy who expired following an oral surgical procedure in the temporomandibular region. During the operation, perforation of the base of the skull occurred causing laceration of a branch of the middle meningeal artery and fatal subdural and epidural bleeding.

Ankylosis↗
PubMed1998

A double blind randomized comparison of oral trimeprazine-methadone and ketamine-midazolam for sedation of pediatric dental patients for oral surgical procedures.

The safety and efficacy of an oral sedation technique for children having minor oral surgical procedures under local anesthesia were studied. One hundred healthy children between the ages of 2 and 7 yr received either a combination of midazolam (0.35 mg/kg) and ketamine (5 mg/kg) (Group A), or a combination of trimeprazine (3 mg/kg) and methadone (0.2 mg/kg) (Group B) 30 min preoperatively. Hemodynamic parameters, adverse reactions, postoperative recovery, and behavior were evaluated. More children were asleep, but rousable to verbal commands, 30 min after drug administration in Group A (40%) than in Group B (8%). Immediately before the dental procedure, 46% of children in Group A were asleep in contrast to 8% of children in group B. Significantly more children in Group A were awake, coughing, crying, and moving purposefully 30 and 60 min after admission to the recovery room. Two children (4%) in Group A vomited. Ten (20%) children in Group A hallucinated compared to none in Group B. The surgeon rated the procedure as good or very good in 94% of children in Group A compared to 78% in Group B. Our results show that the combination of midazolam and ketamine, administered orally, is a safe, effective, and practical approach to managing children for minor oral surgical procedures under local anesthesia.

Administration, Oral↗
PubMed1996

[Oral surgical procedures during anticoagulant therapy].

Minor oral surgery, in patients being treated with anticoagulant therapy, constitutes a problem for the oral and maxillofacial surgeon. 77 patients getting coumarin underwent 168 oral surgical procedures (tooth extraction, apicoectomy, crown-lengthening, excision of lesions) without lowering the dose of anticoagulant. Local hemostasis was achieved in all cases by silk suture. For tooth extraction gelfoam was used as well. In 12 patients who presented with postoperative bleeding, it was controlled in all by gauze pressure with tranexamic acid and/or biologic glue and/or surgical splinting. Postoperative bleeding was not correlated with the international normalized ratio (INR), but with degree of local inflammation. The study shows that interruption of anticoagulant therapy in such cases is not justified, and the use of tranexamic acid or biological glue can control bleeding.

Adult↗
PubMed1980

Hypothalamic-pituitary-adrenal suppression after short-term dexamethasone therapy for oral surgical procedures.

Ten patients were given dexamethasone therapy for prevention of postoperative complications after oral surgical procedures. The hypothalamic-pituitary-adrenal response of the patients was measured by their response to a single-dose metyrapone test. A significant difference was found between preoperative values of 11-deoxycortisol and values three days postoperatively. No difference was found when comparing preoperative values of 11-deoxycortisol with values seven days postoperatively. There appears to be an initial suppression of the normal feedback mechanism of the hypothalamic-pituitary-adrenal axis followed by a complete return of normal functioning by the seventh postoperative day. The amount of surgical stress involved in these routine oral surgical procedures is of an insufficient magnitude to overcome this hypothalamic-pituitary-adrenal suppression of the negative feedback mechanism caused by dexamethasone therapy. The presence of adequate amounts of synthetic steroids at a cellular level appears to prevent manifestations of adrenal insufficiency despite suppression of endogenous production of steroids.

Adult↗
PubMed2001

Patient compliance to instructions after oral surgical procedures.

The purpose of this study was to evaluate patient compliance to postoperative instructions from the oral surgeon. A total of 180 patients who underwent minor oral surgical procedures anonymously answered a questionnaire 1 week postsurgery. This questionnaire was used to evaluate how patients remembered the mode of transmission of instructions (written, verbal), their compliance to the postoperative instructions and to the antibiotic treatment and their comments. Of the patients, 40% did not remember receiving both written and verbal instructions, 36% remembered only the written instructions. Twelve percent did not comply with the postoperative instructions regarding mouthwashes and 67% did not comply with the antibiotic prescriptions; 43% took more antibiotics and 31% less, and 4% who did not receive an antibiotic prescription took them on their own initiative. The academic level of the patients did not influence patient compliance. Verbal and written recommendations worded simply with details are important for patient compliance and reduced postoperative stress and complaints. Better instructions on antibiotics use are necessary to ameliorate patient compliance to the antibiotic treatment.

Adolescent↗
PubMed1987

A comparison of labetalol, acebutolol, and lidocaine for controlling the cardiovascular responses to endotracheal intubation for oral surgical procedures.

Arterial blood pressure and pulse rate changes following tracheal intubation were studied in 80 patients undergoing oral surgical procedures who received an etomidate/suxamethonium anesthetic induction sequence. Three treatment groups and a control group were used. Intravenous labetalol (1 mg/kg), acebutolol (0.25 mg/kg), lidocaine (2 mg/kg), and saline (1 ml), injected prior to anesthesia, were compared with respect to their effect on the hemodynamic consequences of direct laryngoscopy followed by the passage of an endotracheal tube. A pre-induction dose of labetalol was found to be more effective than acebutolol and lidocaine in attenuating the pressor response to instrumentation and intubation. Labetalol should prove most useful for those patients at risk from the transient hypertension and tachycardia following instrumentation and intubation.

Acebutolol↗
PubMedDate not supplied

The effects of psychological desensitization on levels of patient comfort during oral surgical procedures.

The efficacy of psychological desensitization to reduce clinical pain associated with oral surgery was compared to diazepam plus meperidine I.V. Premedication. A visual analog scale was used to rate pain during local anesthesia administration and oral surgery. Psychological desensitization of patients who are to receive only local anesthesia during oral surgical procedures appears to be a significantly effective means of controlling patient pain perception. Such desensitization does not appear to be significant, however, in patients intravenous sedation.

Adult↗
PubMed2000

Does low-dose aspirin therapy complicate oral surgical procedures?

BACKGROUND: The fear of uncontrolled bleeding often prompts medical practitioners to stop aspirin intake for seven to 10 days before any surgical procedure. The authors initiated this study to evaluate the effect of aspirin on bleeding in patients undergoing oral surgery. METHODS: The study group consisted of 39 patients who were scheduled to undergo dental extractions. All patients were receiving 100 milligrams of aspirin daily on a regular basis. The authors randomly divided the patients into two groups: those who stopped the aspirin therapy before the procedure and those who continued the aspirin therapy. One hour before the procedures, all patients underwent a bleeding time test. In addition, the amount of bleeding during the procedure was measured. RESULTS: The mean (+/- standard deviation) bleeding time was 1.8 +/- 0.47 minutes for patients who stopped aspirin therapy one week before the procedure. For patients who continued aspirin therapy, the bleeding time was 3.1 +/- 0.65 minutes. The difference was statistically significant (P = .004). However, both groups were within the normal bleeding time range, and in both groups, a local hemostatic method was sufficient to control bleeding. No episodes of uncontrolled intraoperative or postoperative bleeding were noted. CONCLUSION: Low-dose aspirin therapy should not be stopped before oral surgery. Local hemostasis is sufficient to control bleeding. CLINICAL IMPLICATIONS: Patients receiving aspirin therapy to prevent blood clot formation may be subject to emboli formation if the treatment is stopped. The results of this study show that aspirin therapy should be continued throughout oral surgical procedures. Local measures are sufficient to control any bleeding during surgery.

Adult↗