Cangemi Charles F
J Oral Maxillofac Surg. 2011 Mar;69(3):798-807. doi: 10.1016/j.joms.2009.07.047.
The administration of anesthesia has shifted away from the traditional hospital setting to an enormous increase in the use of outpatient facilities. The development of short-acting anesthetics, advances in surgical techniques, and paradigm shifts accepting targeted hospital admission and preoperative testing have allowed the acceptance of outpatient anesthesia for a wide variety of surgical procedures, including orthognathic procedures. Furthermore, the cost savings associated with office-based surgery and the declining insurance coverage for procedures such as orthognathic surgery have helped to increase the demand for surgery in this setting. The administration of anesthesia for orthognathic surgery in an outpatient setting requires preoperative preparation, preoperative patient assessment and selection, use of short-acting anesthetic agents and techniques, presence of emergency drugs and equipment, appropriate recovery protocols and staff, and the presence of adequate caregivers upon home discharge. Anesthetic techniques and agents allowing multiple orthognathic procedures to be performed in the outpatient setting are described.
麻醉管理已从传统的医院环境转向门诊设施使用的大幅增加。短效麻醉剂的发展、手术技术的进步以及对有针对性的住院和术前检查的观念转变，使得包括正颌手术在内的各种外科手术都能接受门诊麻醉。此外，与门诊手术相关的成本节约以及正颌手术等手术的保险覆盖范围下降，都有助于增加这种环境下的手术需求。在门诊环境中进行正颌手术的麻醉管理需要术前准备、术前患者评估与选择、使用短效麻醉剂和技术、配备急救药物和设备、适当的恢复方案和人员，以及出院回家时有足够的护理人员。本文描述了能使多种正颌手术在门诊环境中进行的麻醉技术和药物。
