- Email: [email protected]
NPO guidelines
Symposia We owe it to our patients to provide the highest level of atraumatic and safe airway management techniques in our current practice of anesthesia and pain control. References Keats AS: Anesthesia mortality in perspective. Anesth Analg 71:113, 1990 Task Force on Guidelines for Management of Difficult Airway Practice: Guidelines for management of the difficult airway. Anesthesiology 78:597, 1993 Delegue L, Guilbert M: Management of airway problems during the repair of craniofacial anomalies in children, in Caronni P (ed): Craniofacial Surgery, Boston, Little, Brown, 1985
NPO Guidelines
As the trend in oral and maxillofacial surgery continues to evolve into more office-based ambulatory procedures, the oral and maxillofacial surgeon must become comfortable with fluid management in the office setting. However, many practitioners still provide no intravenous fluids for their ambulatory anesthesia procedures. Proper perioperative hydration appears to aid in the recovery process and decrease postoperative recovery time. It should become the standard of care in ambulatory anesthesia care in the oral surgery office. References Lustbader DP: Oral Maxillofac Surg Clin North Am 11, 1999 Yongendian S: Anesth Analg 80, 1995 Bennett J: Oral Surg Oral Med Oral Pathol February 2000
David P. Lustbader, DMD, Quincy, MA Fluid therapy has always been an integral part of surgical and anesthetic management of the perioperative patient in the operating room setting. Major maxillofacial surgical procedures require careful fluid evaluation.
Oral Anesthetics Jeffrey D. Bennett, DMD, Farmington, CT (no abstract provided)
SYMPOSIUM ON MAXILLOFACIAL TRAUMA Presented on Saturday, September 13, 8:00 am–10:00 am Moderator: Richard H. Haug, DDS, Lexington, KY
The Philip Maloney Trauma Lecture: Current Concepts in the Treatment of Maxillofacial Trauma Robert D. Marciani, DMD, Cincinnati, OH The importance of facial trauma to the emergence of Oral and Maxillofacial Surgery (OMS) as a specialty underscores the urgency that OMS maintain a primary responsibility in the trauma arena. Surgeons must integrate current surgical concepts in the treatment of maxillofacial trauma with societal changes, economic realities, and complex psychosocial issues frequently associated with the trauma patient. Participation of OMS in the care of the facial trauma patient continues to be problematic for our specialty. Technical and surgical advances in managing facial fractures must be compatible with the costs of dispensing care and the expediency and efficiency of providing fracture repair. What is the ideal surgical treatment plan for a specific fracture cannot be assessed on the basis of a procedure alone. Surgeons must tailor their facial fracture treatment plan within the context of patient’s needs, societal needs in supporting health care, and the enthusiasm of the surgeon to accept the trauma victim as a patient. Oral and maxillofacial surgeons of 75 years ago commonly treated facial fractures by closed methods. The introduction of antibiotics and technological advances AAOMS • 2003
encouraged surgeons to be more aggressive in their surgical approaches and open reduction techniques became more common. Open techniques were clearly justified for patients with facial fractures that could not be restored adequately by closed methods. High velocity injury mechanisms and the marvelous development of rapid, skilled level I trauma center response teams created a growing number of patients with complex facial injuries who earlier would not have survived. Demographics and the substantial increase of a progressively older, active, and potentially less healthy population further influences the management of the facial trauma victim. Choosing a comprehensive patient driven facial fracture treatment plan must go much beyond the latest fixation devices or techniques to less invasively introduce stabilizing hardware. Surgeons must conceptualize the philosophy that “less” surgery may be best for some patients. Surgical approaches that ultimately restore facial form and function less invasively and more economically should always be considered. Current concepts in maxillofacial trauma care must be evaluated and practiced by surgeons who accept facial trauma victims as patients. Every effort should be made to reduce the incidence of facial trauma by all reasonable measures. Creating a willing and well-trained cadre of OMS to manage the at-risk population remains a continuing societal challenge. 19
NPO Guidelines
As the trend in oral and maxillofacial surgery continues to evolve into more office-based ambulatory procedures, the oral and maxillofacial surgeon must become comfortable with fluid management in the office setting. However, many practitioners still provide no intravenous fluids for their ambulatory anesthesia procedures. Proper perioperative hydration appears to aid in the recovery process and decrease postoperative recovery time. It should become the standard of care in ambulatory anesthesia care in the oral surgery office. References Lustbader DP: Oral Maxillofac Surg Clin North Am 11, 1999 Yongendian S: Anesth Analg 80, 1995 Bennett J: Oral Surg Oral Med Oral Pathol February 2000
David P. Lustbader, DMD, Quincy, MA Fluid therapy has always been an integral part of surgical and anesthetic management of the perioperative patient in the operating room setting. Major maxillofacial surgical procedures require careful fluid evaluation.
Oral Anesthetics Jeffrey D. Bennett, DMD, Farmington, CT (no abstract provided)
SYMPOSIUM ON MAXILLOFACIAL TRAUMA Presented on Saturday, September 13, 8:00 am–10:00 am Moderator: Richard H. Haug, DDS, Lexington, KY
The Philip Maloney Trauma Lecture: Current Concepts in the Treatment of Maxillofacial Trauma Robert D. Marciani, DMD, Cincinnati, OH The importance of facial trauma to the emergence of Oral and Maxillofacial Surgery (OMS) as a specialty underscores the urgency that OMS maintain a primary responsibility in the trauma arena. Surgeons must integrate current surgical concepts in the treatment of maxillofacial trauma with societal changes, economic realities, and complex psychosocial issues frequently associated with the trauma patient. Participation of OMS in the care of the facial trauma patient continues to be problematic for our specialty. Technical and surgical advances in managing facial fractures must be compatible with the costs of dispensing care and the expediency and efficiency of providing fracture repair. What is the ideal surgical treatment plan for a specific fracture cannot be assessed on the basis of a procedure alone. Surgeons must tailor their facial fracture treatment plan within the context of patient’s needs, societal needs in supporting health care, and the enthusiasm of the surgeon to accept the trauma victim as a patient. Oral and maxillofacial surgeons of 75 years ago commonly treated facial fractures by closed methods. The introduction of antibiotics and technological advances AAOMS • 2003
encouraged surgeons to be more aggressive in their surgical approaches and open reduction techniques became more common. Open techniques were clearly justified for patients with facial fractures that could not be restored adequately by closed methods. High velocity injury mechanisms and the marvelous development of rapid, skilled level I trauma center response teams created a growing number of patients with complex facial injuries who earlier would not have survived. Demographics and the substantial increase of a progressively older, active, and potentially less healthy population further influences the management of the facial trauma victim. Choosing a comprehensive patient driven facial fracture treatment plan must go much beyond the latest fixation devices or techniques to less invasively introduce stabilizing hardware. Surgeons must conceptualize the philosophy that “less” surgery may be best for some patients. Surgical approaches that ultimately restore facial form and function less invasively and more economically should always be considered. Current concepts in maxillofacial trauma care must be evaluated and practiced by surgeons who accept facial trauma victims as patients. Every effort should be made to reduce the incidence of facial trauma by all reasonable measures. Creating a willing and well-trained cadre of OMS to manage the at-risk population remains a continuing societal challenge. 19