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A study by the American Society of Anesthesiologists (ASA), reported in 2010, found that a lack of understanding and fear about general anesthesia has led to as many as 25% of patients postponing necessary surgery. 1 However, the attitude of patients about having general anesthesia specifically for oral surgery procedures has never been investigated. The purpose of this study was to determine if patients who need to undergo a general anesthetic for oral surgery have the same apprehension as those needing major surgery. It was hypothesized

’’). Off label, triazolam has shown great utility as an anxiolytic-sedative for dental procedures. Orally administered triazolam, 0.5 mg, with 50% nitrous oxide in oxygen produces anxiolytic activity during oral surgery, which is comparable, on average, to 19 mg of intravenous diazepam. 1 Peak plasma levels of orally administered triazolam are generally reached within 2 hours after oral administration, with clinical sedative effects realized in as quickly as 30 minutes. 2 Additionally, triazolam has a short beta half-life, with a reported range of 1.5 to 5.5 hours

Maxillary and mandibular osteotomies may be associated with significant blood loss and postoperative airway compromise. Deliberate hypotensive anesthesia, head up tilt, and local anesthesia with vasoconstrictor can reduce blood loss to the extent that blood transfusion is now uncommon. 1 It is, however, important to avoid excessive opioid-induced postoperative narcosis and respiratory depression associated with these techniques. Anesthetic maintenance with propofol and remifentanil is fast becoming the technique of choice for orthognathic surgery in our

Hyperthyroidism is a preexisting disorder that is occasionally encountered by anesthesiologists during preanesthetic evaluations. Hyperthyroidism is usually accompanied by allergies, and there is a suggested relationship between the development of hyperthyroidism and the exacerbation of allergic disease. 1 Here, we report a case with palmoplantar pustulosis and hyperthyroidism diagnosed after simultaneous bimaxillary orthognathic surgery. The patient was a 39-year-old woman (height, 153.2 cm; weight, 48.4 kg) who suffered from

In the field of oral and maxillofacial surgery, the removal of impacted third molars is considered a routine procedure. 1 This procedure can lead to painful symptoms, swelling, and disorders that may be transitory or permanent, including trismus and paresthesia. Pain is considered severe by 93% of patients in the first 24 to 48 hours after surgery. 2 Therefore, preoperative intake of anti-inflammatories should be considered to minimize pain (preemptive analgesia), swelling, and trismus in the postoperative period. 3 Preemptive

the airway was finally successfully controlled by cricothyrotomy. Piepho et al 3 concluded that laryngoscopy should be performed first and then NTI attempted if a Cormack-Lehane grade 1 or 2 view of the vocal cords is obtained, whereas other means of protecting the airway (eg, fiber-optic or supraglottic techniques) should be used for grade 3 or 4 views. Anesthesiologists often face further challenges during nonelective trauma cases for oral and maxillofacial surgery. Trauma frequently causes significant airway edema and, along with associated cervical

Major diseases requiring surgical treatment in the oral and maxillofacial region include malignant tumor, jaw deformity, and cleft lip and palate. Because both oral mucosa and bone marrow, which have abundant blood flow, are part of the surgical field, control of bleeding to ensure a clear surgical field is important for the smooth progression of surgery. Reduction of bleeding also helps to limit allogeneic blood transfusions and decrease the need for autologous blood transfusion, potentially enabling swifter postoperative recovery and fewer

portions of surgery. The short clinical half-lives of these opioids are particularly beneficial for ambulatory anesthesia, since patients tend to recover faster and have fewer side effects or complications once the drugs are either quickly redistributed or metabolized. Infusion combinations of propofol and remifentanil for induction and maintenance of deep sedation or nonintubated general anesthesia (DS/GA) have been shown to be safe and effective in providing analgesia, stable sedation/hypnosis, and satisfactory operating conditions along with a shorter recovery

referred to the Nagoya City University Graduate School of Medical Sciences Department of Oral and Maxillofacial Surgery for evaluation of right mandibular tenderness diagnosed as osteomyelitis. Preoperative evaluation revealed moderate cardiac enlargement by chest radiograph (cardiothoracic ratio: 52%). Table 1.  Medical History Timeline* Sinus bradycardia (heart rate: 44 beats/min) and negative T waves (II, III, aV F , V3–6) were observed by 12-lead electrocardiogram

embolic stroke occurs when a blood clot or other debris forms away from the brain and is carried through the bloodstream to lodge in narrower brain arteries. Another cause of stroke is when bleeding occurs into brain tissue from a ruptured blood vessel (hemorrhagic stroke). 3 Stroke is a leading cause of morbidity and mortality. 4 Perioperative acute ischemic stroke is a recognized complication of noncardiac, nonvascular surgery. 5 Among the general population, the rate of acute ischemic stroke in the perioperative period has been reported to be as high as 0