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在门诊环境下,牙科医院手术室的过夜住院和/或延长恢复期可能允许进行长时间的口腔颌面外科手术:单中心经验。

Overnight hospital stay and/or extended recovery period may allow long-duration oral and maxillofacial surgeries in the operating room of a dental hospital in an outpatient setting: a single-center experience.

作者信息

Uzumcugil Filiz, Ankay Yilbas Aysun, Akca Basak, Ozkaragoz Demet Basak, Adiloğlu Selen, Tuz Hıfzı Hakan, Kanbak Meral

机构信息

Department of Anesthesiology and Reanimation, Hacettepe University School of Medicine, Ankara, Turkey.

Department of Oral and Maxillofacial Surgery, Hacettepe University Faculty of Dentistry, Ankara, Turkey.

出版信息

J Korean Assoc Oral Maxillofac Surg. 2020 Apr 30;46(2):125-132. doi: 10.5125/jkaoms.2020.46.2.125.

DOI:10.5125/jkaoms.2020.46.2.125
PMID:32364352
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7222620/
Abstract

OBJECTIVES

The requirement for overnight hospital stay should be considered preoperatively according to patient-related factors, type of surgery, and anesthetic management plan. In this study, we aimed to define the major factors that influence consideration of overnight hospital stay in patients undergoing oral and maxillofacial (OMF) surgery in an operating room (OR) of a dental hospital in an outpatient setting.

MATERIALS AND METHODS

The records of patients who underwent oral procedures under general anesthesia between 2014-2017 were reviewed.

RESULTS

A total of 821 patients underwent oral procedures under general anesthesia; 631 of them underwent OMF surgery in the OR of a dental hospital, and 174 of these patients were hospitalized for overnight stay. There was no significant difference in the number of patients with comorbidities between the outpatient and hospitalized patient groups (=0.389). The duration of surgery was longer in the hospitalized patient group (105.25±57.48 vs 189.62±82.03 minutes; P<0.001). Double-jaw (n=15; 310.00±54.21 minutes) and iliac crest grafting surgeries (n=59; 211.86±61.02 minutes) had the longest durations. Patients who underwent iliac crest grafting had the highest rates of hospitalization (79%). The overall recovery period was longer in outpatients (119.40±41.60 vs 149.83±52.04; <0.001).

CONCLUSION

Duration of surgery was the main determinant in considering whether a patient required overnight hospital stay. However, patients with an American Society of Anesthesiology physical status score <3 may be scheduled for OMF surgery in the OR of a dental hospital in an outpatient setting regardless of duration of surgery if overnight hospital stay is planned or an extended recovery period is provided until patients meet the discharge criteria.

摘要

目的

应根据患者相关因素、手术类型及麻醉管理计划,在术前考虑患者是否需要住院过夜。在本研究中,我们旨在确定影响在牙科医院门诊手术室接受口腔颌面外科(OMF)手术患者住院过夜决策的主要因素。

材料与方法

回顾了2014年至2017年间在全身麻醉下接受口腔手术患者的记录。

结果

共有821例患者在全身麻醉下接受口腔手术;其中631例在牙科医院手术室接受OMF手术,这些患者中有174例住院过夜。门诊患者组和住院患者组合并症患者数量无显著差异(P=0.389)。住院患者组手术时间更长(105.25±57.48分钟 vs 189.62±82.03分钟;P<0.001)。双颌手术(n=15;310.00±54.21分钟)和髂骨移植手术(n=59;211.86±61.02分钟)手术时间最长。接受髂骨移植的患者住院率最高(79%)。门诊患者的总体恢复期更长(119.40±41.60天 vs 149.83±52.04天;P<0.001)。

结论

手术时间是决定患者是否需要住院过夜的主要因素。然而,如果计划住院过夜或提供延长的恢复期直至患者符合出院标准,美国麻醉医师协会身体状况评分<3的患者,无论手术时间长短,都可在牙科医院门诊手术室安排进行OMF手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e206/7222620/2582dc214c20/JKAOMS-46-125-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e206/7222620/f6d373a97581/JKAOMS-46-125-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e206/7222620/1950bc044192/JKAOMS-46-125-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e206/7222620/2582dc214c20/JKAOMS-46-125-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e206/7222620/f6d373a97581/JKAOMS-46-125-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e206/7222620/1950bc044192/JKAOMS-46-125-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e206/7222620/2582dc214c20/JKAOMS-46-125-f3.jpg

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Discharge Criteria, Impact of the Patient and the Procedure: What the Oral Surgeon Should Know.出院标准、患者及手术的影响:口腔外科医生应了解的内容。
Oral Maxillofac Surg Clin North Am. 2017 May;29(2):197-208. doi: 10.1016/j.coms.2016.12.009.
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Post-operative Bleeding Risk in Dental Surgery for Patients on Oral Anticoagulant Therapy: A Meta-analysis of Observational Studies.
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Front Pharmacol. 2017 Feb 8;8:58. doi: 10.3389/fphar.2017.00058. eCollection 2017.
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