Comparison of General Anesthesia With Isoflurane/N2O and Propofol/Alfentanil on Optimal Extubation in Mandibular Fractures With Arch Bar
Archives of Critical Care Medicine,
Vol. 1 No. 3 (2015),
27 October 2023
Abstract
Background: Due to the use of the arch bar in many of jaw fractures and fixation of mandible and maxilla, lack of adequate access to airways and further bleeding during surgery, recognition of anesthetic agents that produce better hemodynamic stability and recovery has special importance. Objectives: The aim of this study was to compare the maintenance of anesthesia with propofol/alfentanil versus isoflurane/N2O in patients candidate for arch bar fixation.
Patients and Methods: In this randomized, double-blind clinical trial, 60 patients were randomly divided into two equal groups of P (propofol + alfentanil) and I (isoflurane + N2O). Blood pressure and heart rate were measured every five minutes, since 5 minutes before induction to 15 minutes after extubation. Presence of backing and level of patient cooperation were also recorded.
Results: The mean systolic blood pressure after extubation was significantly higher in group P (P = 0.024). Time interval between discontinuation of anesthetics and extubation was significantly lower in group P (P = 0.015).
Conclusions: Patients who received propofol/alfentanil were extubated in shorter time than those who received isoflurane/N2O.
- Anesthesia
- Mandibular Fractures,
- Airway Extubation
How to Cite
References
West GH, Griggs JA, Chandran R, Precheur HV, Buchanan W, Caloss
R. Treatment outcomes with the use of maxillomandibular fixation
screws in the management of mandible fractures. J Oral Maxillofac Surg. 2014;72(1):112–20. doi: 10.1016/j.joms.2013.08.001. [PubMed:
.
Bissada E, Abou-Chacra Z, Ahmarani C, Poirier J, Rahal A. Intermaxillary screw fixation in mandibular fracture repair. J Otolaryngol Head
Neck Surg. 2011;40(3):211–5. [PubMed: 21518642].
Piffko J, Homann C, Schuon R, Joos U, Meyer U. Experimental study on
the biomechanical stability of different internal fixators for use in the
mandible [in German]. Mund Kiefer Gesichtschir. 2003;7(1):1–6.
Miller RD. Miller’s Anesthesia. London: Churchill Livingstone; 2010.
Werner ME, Bach DE, Newhouse RF. A comparison of propofol with
methohexital and isoflurane in two general anesthetic techniques. J
Oral Maxillofac Surg. 1993;51(10):1076–9. [PubMed: 8410445].
Habre C, Tramer MR, Popping DM, Elia N. Ability of a meta-analysis
to prevent redundant research: systematic review of studies on pain
from propofol injection. Bmj. 2014;348:g5219. doi: 10.1136/bmj.g5219.
[PubMed: 25161280].
Draskovic B, Knezevic S, Radovanovic D, Rakic G. [Ondansetron, alfentanil and nitrous oxide in the prevention of pain on injection of
propofol]. Srp Arh Celok Lek. 2013;141(1-2):61–5. [PubMed: 23539912].
Lang XE, Wang X, Jin JH. Mechanisms of cardioprotection by isoflurane against I/R injury. Front Biosci (Landmark Ed). 2013;18:387–93.
[PubMed: 23276931].
Lazow SK. The mandible fracture: a treatment protocol. J Craniomaxillofac Trauma. 1996;2(2):24–30. [PubMed: 11951480].
Gutta R, Tracy K, Johnson C, James LE, Krishnan DG, Marciani RD. Outcomes of mandible fracture treatment at an academic tertiary hospital: A 5-year analysis. J Oral Maxillofac Surg. 2014;72(3):550–8.
Fonseca RJ, Barber HD, Matheson JD. Oral and Maxillofacial Surgery:
Anesthesia and pain control, dentoalveolar surgery, practice management implant surgery. United State: Saunders; 2008.
Nelskyla K, Korttila K, Yli-Hankala A. Comparison of sevofluranenitrous oxide and propofol-alfentanil-nitrous oxide anaesthesia
for minor gynaecological surgery. Br J Anaesth. 1999;83(4):576–9.
[PubMed: 10673872].
Hong JY, Oh JI, Kim SM. Comparison of sevoflurane-nitrous oxide and
target-controlled propofol with fentanyl anesthesia for hysteroscopy.
Yonsei Med J. 2002;43(4):420–6. [PubMed: 12205728].
Bali IM, Kendrick RW. Alfentanil and isoflurane anaesthesia for
day stay dental surgery. Anaesthesia. 1985;40(7):702–3. [PubMed:
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