A report of 14,195 applications of anesthetics to oral and maxillofacial surgery at one teaching dental hospital (1971-2000) centering around airway problems.

STUDY OBJECTIVES To examine the validity of our methods of anesthesia, i.e., awake intubation and assisted manual ventilation, in coping with the anesthetic problems particular to oral and maxillofacial surgery (OMF surgery). DESIGN Prospective study. SETTING Operating room and ward of a dental teaching hospital. PATIENTS 14,195 patients undergoing OMF surgery during the period from January 1971 to March 2000. MEASUREMENTS AND MAIN RESULTS The kinds of anesthetic difficulties centering around airway problems and their frequency in OMF surgery were determined. In 2,401 patients (16.9%), awake intubation was employed because of definite or possible airway problems. No untoward effects due to awake intubation were noted. Volatile anesthetics were used with nitrous oxide (N2O) in 13,959 patients (98.3%), and their spontaneous respiration were assisted manually for the purpose of early detection of airway troubles such as accidental extubation, dislocation, kinking, and/or damage to the endotracheal tubes. Few accidents or complications were noted in relation to airway issues, and neither cardiac arrest nor death was experienced in these 14,195 patients. CONCLUSIONS Based on a sufficient number of anesthetic applications, awake intubation and assisted manual ventilation were proved to be useful in coping with the anesthetic difficulties particular to OMF surgery.