Sim K M, Boey S K
National Dental Centre, 5, Second Hospital Avenue, Singapore 168938.
Singapore Dent J. 2000 Dec;23(1 Suppl):29-37.
Outpatient general anaesthesia (GA) is administered for extraction of carious teeth in children and straightforward dento-alveolar surgery such as removal of impacted teeth, cyst enucleation and dental implantology in adults. Although oral surgery is often performed under local anaesthesia, GA is indicated in conditions when local anaesthesia is ineffective and in uncooperative patients because of age, fear or anxiety, mental impairment or physical disability. Outpatient GA for oral surgery yields a high satisfaction score from the patients. The incidence of major morbidity is acceptably low because of proper patient and procedure selection, improved perioperative patient monitoring, and the use of newer, faster recovery anaesthetic agents with fewer side-effects. Effective pain management is important for optimal postoperative analgesia and patient satisfaction. The principles, conduct, and management of common problems of outpatient GA for oral surgery are discussed.
门诊全身麻醉(GA)用于儿童龋齿拔除以及成人简单的牙槽外科手术,如阻生牙拔除、囊肿摘除和牙种植术。尽管口腔手术通常在局部麻醉下进行,但当局部麻醉无效时,以及因年龄、恐惧或焦虑、精神障碍或身体残疾而不配合的患者,仍需进行全身麻醉。门诊口腔手术全身麻醉能让患者获得较高的满意度评分。由于患者和手术选择得当、围手术期患者监测得到改善,以及使用了更新、恢复更快且副作用更少的麻醉剂,严重并发症的发生率低至可接受水平。有效的疼痛管理对于实现最佳术后镇痛和患者满意度至关重要。本文将讨论门诊口腔手术全身麻醉常见问题的原则、实施和管理。