全身管理の立場からみた口腔外科手術 −歯科麻酔医からの視点−

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  • 宮脇 卓也
    岡山大学大学院医歯薬学総合研究科歯科麻酔・特別支援歯学分野

書誌事項

タイトル別名
  • General management of patients undergoing oral maxillofacial surgery − viewpoints of dental anesthesiologists −
  • 全身管理の立場からみた口腔外科手術 : 歯科麻酔医からの視点
  • ゼンシン カンリ ノ タチバ カラ ミタ コウコウ ゲカ シュジュツ : シカ マスイイ カラ ノ シテン

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<p>Dental anesthesiologists have the following roles in oral and maxillofacial surgery: providing patients with high-quality anesthesia during operations, providing the best conditions for surgeons in an operating room, having to ensure patients have no complications, and relieving pain and anxiety of patients after operations. To achieve these, close cooperation with oral and maxillofacial surgeons is essential, and the general preoperative management of patients, especially preoperative evaluation, is very important. So, in the present review I focused on the following topics that should be considered on preoperative evaluation:</p><p>1） Preoperative image inspection of oral and maxillofacial regions, including Cephalo X-ray, C-T, and MR imaging of the head and neck region, is clinically useful to predict the airway condition of patients during and after operations under general anesthesia.</p><p>2） Preoperative respiratory conditions and lung diseases of patients undergoing operations under general anesthesia should be carefully evaluated because general anesthesia generally inhibits the respiratory function. So, the operation should be delayed until the respiratory condition improves if possible.</p><p>3） Preoperative cardiovascular conditions of patients undergoing operations should be evaluated according to evidence-based guidelines incorporating stepwise assessments, such as “Active Cardiac Condition” or not, physical ability, and other complications. In the case of patients with poor conditions, consultation with specialists of cardiovascular diseases is necessary. The goal is to minimize the incidence of cardiovascular complications in patients during and after operations.</p><p>4）The blood pressure and pulse rate (ECG if necessary) should be monitored in patients with cardiovascular disease such as hypertension during operations, even during tooth extraction under local anesthesia.</p>

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