Edwards D J, Brickley M R, Horton J, Edwards M J, Shepherd J P
University of Wales College of Medicine, Department of Oral Surgery, Pathology and Medicine, Cardiff, UK.
Br J Oral Maxillofac Surg. 1998 Oct;36(5):333-40. doi: 10.1016/s0266-4356(98)90643-x.
A prospective investigation was carried out to find out which factors affected the choice of anaesthetic for 444 consecutive patients (153 male, 291 female, age range 15-85) listed for extraction of third molars. Two hundred and seventy-two were listed for treatment under general anaesthesia, 120 (44%) as inpatients and 152 (60%) as day cases. The remaining 144 (32%) patients were to be treated under local anaesthesia and 28 (6%) with additional intravenous sedation. Logistic regression analysis showed that difficulty of surgery, patients' anxiety, patients' preferences, medical history, and number of teeth to be removed were important predictors of choice of anaesthetic. From an anaesthetist's perspective, many more patients should have been treated under local anaesthesia with intravenous sedation and fewer should have been listed for inpatient extraction under general anaesthesia.
开展了一项前瞻性调查，以确定哪些因素影响了连续444例（153例男性，291例女性，年龄范围15 - 85岁）计划拔除第三磨牙患者的麻醉选择。其中272例计划在全身麻醉下进行治疗，120例（44%）为住院患者，152例（60%）为日间手术患者。其余144例（32%）患者将在局部麻醉下接受治疗，28例（6%）患者将额外接受静脉镇静。逻辑回归分析表明，手术难度、患者焦虑程度、患者偏好、病史以及要拔除的牙齿数量是麻醉选择的重要预测因素。从麻醉医生的角度来看，应该有更多患者接受局部麻醉加静脉镇静治疗，而应安排接受全身麻醉住院拔牙的患者则应更少。
