Oral & Maxillofacial Surgery Evidence Update July 2017 Bimonthly

Background: Dexmedetomidine provides smooth emergence with reduced agitation. The authors hypothesized low-dose dexmedetomidine infusion might contribute to hemodynamic stability during and after nasotracheal tube extubation. [ABSTRACT EDITED] Evaluation of different doses of dexmedetomidine alone versus the combination of dexmedetomidine and fentanyl in sedation during awake fiberoptic intubation in oral cancer surgery patients: A prospective, randomized, double-blind clinical trial Author(s): Hassan M.E.; Mahran E. Source: Saudi Journal of Anaesthesia; 2017; vol. 11 (no. 2); p. 196-202 Publication Type(s): Article Available in full text at Saudi Journal of Anaesthesia from ProQuest Abstract:Background: Awake fiberoptic intubation (AFOI) is one of the principal techniques in the management of difficult airway in oral cancer surgery. We hypothesized that the addition of a small dose of fentanyl could improve the sedative criteria of dexmedetomidine during AFOI technique, without the need to increase the dose of dexmedetomidine which may be associated with airway compromise. [ABSTRACT EDITED]. Sindrome della morte improvvisa o di Brugada in chirurgia orale: Caso clinico e revisione della letteraturaSudden unexpected death or Brugada syndrome in oral surgery: A case report and literature review Author(s): Paradiso D.; Lomurno G.; Eramo S.; Bensi C. Source: Dental Cadmos; 2017; vol. 85 (no. 2); p. 104-111 Publication Type(s): Article Abstract:OBJECTIVES. The aim of this study is to present a case of Brugada syndrome in a patient requiring oral surgery. A review of the literature is also provided. [ABSTRACT EDITED] A case of psychogenic non-epileptic seizures after oral surgery under general anesthesia Author(s): Ushiroda J.; Kawaguchi M. Source: Journal of Japanese Dental Society of Anesthesiology; 2017; vol. 45 (no. 1); p. 32-34 Publication Type(s): Article Abstract:We report a case of psychogenic non-epileptic seizures after general anesthesia. A 62-yearold woman underwent resection of the coronoid processes and dissection of the masseter muscle under general anesthesia. The surgical procedures were performed uneventfully, and there were no specific problems during the operation. After the operation, she regained consciousness and was neurologically intact. While exiting the operating room floor, she lost consciousness for a moment immediately after complaining of difficulty breathing. However, she regained consciousness soon thereafter. We judged that she had no problem with her status, so she went back to the surgical ward. Afterwards, she developed systemic convulsions, including a loss of consciousness and respiratory arrest. An emergent head CT exam and arterial blood gas analysis did not show any pathological density, structural change, or abnormal values. Later, we discovered that she had experienced the same symptoms after previous surgical operations. We speculated that she was experiencing psychogenic non-epileptic seizures (PNES) because a subsequent elecTroencephalogram exam did not show any abnormal waves. PNES is considered to be a partial symptom of dissociative disorder. The condition may be triggered by psychological problems consisting of severe anxiety and mental conflict. A prompt differential diagnosis between a true epilepsy attack and PNES is usually difficult because the diagnosis of PNES is based mainly on