A report of 14,195 applications of anesthetics to oral and maxillofacial surgery at one teaching dental hospital (1971-2000) centering around airway problems

Study Objectives: To examine the validity of our methods of anesthesia, i.e ., awake intubation and assisted manual ventilation. in coping with the ane sthetic problems particular to oral and maxillofacial surgery (OMF surgery) . Design: Prospective study. Setting: Operating room and ward of a dental teaching hospital. Patients: 14, 195 patients undergoing OMF surgery during the period from Ja nuary 1971 to March 2000. Measurements and Main Results: The kinds of anesthetic difficulties centeri ng around airway problems and their frequency in OMF surgery were determine d. In 2, 401 patients (16.9%), awake intubation was employed because of def inite or possible airway problems. No untoward effects due to awake intubat ion were noted. Volatile anesthetics were used with nitrous oxide (N2O) in 13, 959 patients (98.3 %), and their spontaneous respiration were assisted, manually for the purpose of early detection of airway troubles such as acci dental extubation, dislocation, kinking and/or damage to the endotracheal t ubes. Few accidents or complications were, noted in relation to airway issu er, and neither cardiac arrest nor death was experienced in these 14, 195 p atients. Conclusions: Based on a sufficient number of anesthetic applications, awake intubation and assisted manual ventilation were proved to be useful in cop ing with the a anesthetic difficulties particular to OMF surgery. (C) 2000 by Elsevier Science Inc.