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
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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 (P=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; P<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.
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 (P=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; P<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.
참고문헌 (14)
- Stronczek MJ, "Determining the appropriate oral surgery anesthesia modality, setting, and team", Oral Maxillofac Surg Clin North Am, 25, pp.357~366 (2013)
- Lieblich S, "Preoperative evaluation and patient selection for officebased oral surgery anesthesia", Oral Maxillofac Surg Clin North Am, 30, pp.137~144 (2018)
- Verco S, "A five-year assessment of clinical incidents requiring transfer in a dental hospital day surgery unit", Aust Dent J, 56, pp.412~416 (2011)
- Özkan AS, "Retrospective evaluation of dental treatment under general anaesthesia", Turk J Anaesthesiol Reanim, 43, pp.332~336 (2015)
- Whippey A, "Predictors of unanticipated admission following ambulatory surgery : a retrospective case-control study", Can J Anaesth, 60, pp.675~683 (2013)
- Jastak JT, "Major morbidity or mortality from office anesthetic procedures : a closed-claim analysis of 13 cases", Anesth Prog, 38, pp.39~44 (1991)
- Aldrete JA, "The post-anesthesia recovery score revisited", J Clin Anesth, 7, pp.89~91 (1995)
- Cortiñas-Saenz M, "Results of a major ambulatory oral surgery program using general inhalational anesthesia on disabled patients", Med Oral Patol Oral Cir Bucal, 14, pp.e605~e611 (2009)
- Kramer KJ, "Discharge criteria, impact of the patient and the procedure : what the oral surgeon should know", Oral Maxillofac Surg Clin North Am, 29, pp.197~208 (2017)
- Broekema FI, "Risk of bleeding after dentoalveolar surgery in patients taking anticoagulants", Br J Oral Maxillofac Surg, 52, pp.e15~e19 (2014)
- Bajkin BV, "Risk factors for bleeding after oral surgery in patients who continued using oral anticoagulant therapy", J Am Dent Assoc, 146, pp.375~381 (2015)
- Shi Q, "Post-operative bleeding risk in dental surgery for patients on oral anticoagulant therapy : a metaanalysis of observational studies", Front Pharmacol, 8, pp.58~ (2017)
- Cruthirds D, "Review and recommendations for the prevention, management, and treatment of postoperative and postdischarge nausea and vomiting", Oral Surg Oral Med Oral Pathol Oral Radiol, 115, pp.601~611 (2013)
- Rastogi A, "Comparison of general anaesthesia versus regional anaesthesia with sedation in selected maxillofacial surgery : a randomized controlled trial", J Craniomaxillofac Surg, 42, pp.250~254 (2014)