OUTCOMES AFTER SAME-DAY ORAL-SURGERY - A REVIEW OF 1,180 CASES AT A MAJOR TEACHING HOSPITAL

Outcome was measured from data collected on 1,180 consecutive ambulatory oral surgery patients, two thirds of whom were treated under general anesthesia and the remainder who were treated under local anesthesia supplemented with intravenous sedation. Three patients (0.25%) required admission on the day of surgery; all had undergone general anesthesia. The surgery-related complication rate in the general anesthesia group (1:132) was similar to that for local anesthesia and sedation (1:128). However, anesthesia-related complications had an incidence of 1:99 in the general anesthesia group, but were absent in those receiving local anesthesia and sedation. Eight patients (0.7%) required hospital readmission after being discharged, mostly because of complications of surgery. The incidence of postoperative nausea and vomiting in the recovery room after local anesthesia and sedation (6%) was less than after general anesthesia (14%) (P < .01) Average recovery times to sitting out of bed and being ready for discharge were less after local anesthesia and sedation (38 ± 15 minutes and 120 ± 39 minutes, respectively) than after general anesthesia (61 ± 50 minutes and 141 ±62 minutes). At the time of follow-up during the first few postoperative days, 7% of patients had gone to a family doctor and 4% to hospital accident and emergency departments, usually for minor problems. Paracetamol 500 mg plus codeine phosphate 30 mg was effective in 97% of cases when provided as a take-home analgesic. Ninety-nine percent of patients were satisfied with their management. © 1993, American Association of Oral and Maxillofacial Surgeons. All rights reserved.. All rights reserved.