A clinical audit on antibiotic prescribing in the Oral Surgery Department following General Anaesthetic and Intravenous sedation outpatient procedures at Guy's Dental Hospital

Introduction: A rise in post-operative complications (POCs) was observed following the second national lockdown due to the ongoing Coronavirus 2019 (COVID-19) pandemic. This prompted our Oral Surgery Department to investigate this to understand why this increase had occurred. Aim: To evaluate the rise in POCs at The Eastman Dental Hospital Oral Surgery Department during and after the COVID-19 pandemic lockdown. Materials and methods: A two cycle audit to assess the effect of the restrictions and ease imposed by lockdown on the number of POCs reported within the department. Results: A spike in POCs was observed during the second lockdown. Following the ease of these restrictions, POCs reduced by half. Discussion: As lockdown eased, the number of patient’s contacting the department following surgical procedures significantly reduced. Did the pandemic cause patients to become more observant with regards to their post-operative site? Conclusions: COVID-19 has had a lasting effect amongst our society and healthcare professionals are seeing not only the physical detriment but also the mental effects on our patients. We must ask if the increase in our POCs be caused by underlying “health anxiety” amongst members of the general public and if so, how can it be overcome?

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Capnometry monitoring during intravenous sedation with midazolam for oral surgery

Oral Surgery ◽

10.1111/ors.12169 ◽

2015 ◽

Vol 9 (2) ◽

pp. 94-101 ◽

Cited By ~ 4

Author(s):

P.J. Brady ◽

K.E. Wilson ◽

R. Meeke ◽

N.M. Girdler ◽

C. Mc Creary

Keyword(s):

Oral Surgery ◽

Intravenous Sedation

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Physician Courtesy and Patient Satisfaction in a Pediatric Plastic and Oral Surgery Department

Journal of Healthcare Management ◽

10.1097/jhm-d-16-00002 ◽

2017 ◽

Vol 62 (3) ◽

pp. 211-219 ◽

Cited By ~ 1

Author(s):

Kimberly M. Daniels ◽

Rachel R. Yorlets ◽

Susan J. Flath-Sporn ◽

Brian I. Labow ◽

Ronald R. Heald ◽

...

Keyword(s):

Patient Satisfaction ◽

Oral Surgery ◽

Surgery Department

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Avascular osteonecrosis of the premaxilla secondary to disseminated intravascular coagulation: a case report

Journal of Oral Medicine and Oral Surgery ◽

10.1051/mbcb/2018016 ◽

2018 ◽

Vol 24 (4) ◽

pp. 173-177

Author(s):

Alizée Mouraret ◽

Eric Gérard ◽

Joey Le Gall ◽

Rémi Curien

Keyword(s):

Disseminated Intravascular Coagulation ◽

Oral Surgery ◽

Disease Process ◽

Vascular Supply ◽

Pathological State ◽

Avascular Osteonecrosis ◽

Bone Necrosis ◽

Intravascular Coagulation ◽

Severity Of The Disease ◽

Surgery Department

Introduction:Disseminated intravascular coagulation (DIC) is a complexe systemic disorder characterized by a widespread activation of the coagulation, that may lead to thrombosis, ischemia and finally, end-organ failure. The clinical presentation of DIC depends on the site of intravascular coagulation and the severity of the disease process. Avascular osteonecrosis is a pathological state, that can occur secondary to DIC and where a reduced vascular supply leads to ischemia and bone necrosis.Observation:A 83 years old patient was sent to the oral surgery department for tooth mobility in the premaxilla, following the diagnosis of sepsis and DIC induced acute myeloid leukemia, one month ago. The examination showed an exposed avascular bone behind the 12-11-21. A diagnosis of DIC induced osteonecrosis of the premaxilla was made. A resection surgery was then programmed.Discussion:DIC may generates thrombi that might occlude intraosseous vessels in the premaxilla, and lead to bone necrosis. The maxilla is supplied by multiple branches of external carotide artery, therefore, usually, there is a lower risk of osteonecrosis in the maxilla. Nevertheless, since 1993, 4 cases of avascular necrosis of the maxilla secondary to DIC are repported in literature.Conclusion:This kind of complication, although being rare, can be dramatic for the patient as bone and aesthetic defects. Early support and management of these complications is necessary.

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Antimicrobial prescribing patterns in surgical inpatient of tertiary care hospital in Eastern India

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20193199 ◽

2019 ◽

Vol 8 (8) ◽

pp. 1902

Author(s):

Sumit Kumar Gupta ◽

Siddhartha Ghosh

Keyword(s):

Tertiary Care ◽

Relevant Information ◽

Prescribing Patterns ◽

Antibiotic Prescribing ◽

Antibiotic Administration ◽

Care Hospital ◽

Beta Lactam ◽

Cross Sectional ◽

Before And After ◽

Surgery Department

Background: Antimicrobials form the cornerstone of prescriptions for treating infection. Surgical management cannot be possible without the use of antibiotics. Severity of infection, suspected spectrum of organisms and their sensitivity, co-morbidities of the patient, route of antibiotic administration are the important parameter to consider before selecting antibiotic.Methods: Cross-sectional, hospital based, descriptive study was conducted in the ward of Surgery Department of IQ City Medical college, Durgapur over a period of 1 year. The relevant information was entered into the pretested preformats (containing name, age, sex, diagnosis, ongoing treatment as recorded from patients’ prescription slips or CRFs) and analyzed. Necessary permission was granted by the Institutional Ethical Committee and written informed consent was obtained from the patients prior to collecting their prescription slips/CRF.Results: Commonest cause of hospitalization was cholelithiasis (318 (32.7%)). Antimicrobials were the most commonly prescribed drugs (1626 (31.6%)). Single antibiotic prescribing frequency are similar to two antibiotic prescribing (both 44%). Piperacillin+Tazobactum combination most commonly prescribe antibiotic.Conclusions: Beta lactam antibiotic specifically Piperacillin (ATC class: J01D) were the most commonly prescribed antibiotic agents both before and after surgical procedures.

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Analgesia and anaesthesia

Oxford Handbook of Emergency Medicine ◽

10.1093/med/9780198784197.003.0007 ◽

2020 ◽

pp. 281-327

Author(s):

Jonathan P. Wyatt ◽

Robert G. Taylor ◽

Kerstin de Wit ◽

Emily J. Hotton ◽

Robin J. Illingworth ◽

...

Keyword(s):

Emergency Department ◽

Nerve Block ◽

Local Anaesthetic ◽

Local Anaesthesia ◽

Femoral Nerve Block ◽

Rapid Sequence Induction ◽

Femoral Nerve ◽

General Anaesthetic ◽

Intravenous Sedation ◽

Nerve Blocks

This chapter in the Oxford Handbook of Emergency Medicine investigates analgesia and anaesthesia in the emergency department (ED). It looks at options for relieving pain, such as the analgesics aspirin, paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), morphine and other opioids, Entonox®, and ketamine, and explores analgesia for trauma and other specific situations. It discusses local anaesthesia (LA) and local anaesthetic toxicity, including use of adrenaline (epinephrine) and general principles of local anaesthesia. It explores blocks such as Bier’s block, local anaesthetic nerve blocks, intercostal nerve block, digital nerve block, median and ulnar nerve blocks, radial nerve block at the wrist, dental anaesthesia, nerve blocks of the forehead and ear, fascia iliaca compartment block, femoral nerve block, and nerve blocks at the ankle. It examines sedation, including drugs for intravenous sedation and sedation in children, and discusses general anaesthesia in the emergency department, emergency anaesthesia and rapid sequence induction, difficult intubation, and general anaesthetic drugs.

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Observational Study on the Preparation of the Implant Site with Piezosurgery vs. Drill: Comparison between the Two Methods in terms of Postoperative Pain, Surgical Times, and Operational Advantages

BioMed Research International ◽

10.1155/2019/8483658 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Michele Maglione ◽

Lorenzo Bevilacqua ◽

Federica Dotto ◽

Fulvia Costantinides ◽

Felice Lorusso ◽

...

Keyword(s):

Postoperative Pain ◽

Operative Time ◽

Oral Surgery ◽

Study Groups ◽

Site Preparation ◽

Medical Sciences ◽

Operative Duration ◽

Significant Difference ◽

Surgery Department ◽

Implant Site Preparation

Purpose. Recent advances show that ultrasonic implant site osteotomy is related to a decreased trauma and a better postoperative healing of the surgical site when compared to traditional drilling techniques. The micrometric bone cutting control and the operative advantages related to the piezoelectric approach are also characterized by a learning curve for the clinician in surgical practice and an increased operative duration of the procedure. The aim of this investigation is to compare the operative time, the postoperative pain, and the amount of painkillers taken by the patient during the healing period. Methods. A total of 65 patients were treated at the Unit of Oral Surgery (Department of Medical Sciences, Surgery and Health, University of Trieste, Italy) using a split mouth model: 75 drill-inserted implants (G1) and 75 piezoelectric device-inserted implants (G2) were placed. The Visual Analogue Scale (VAS) was performed to evaluate the postoperative pain at 15 days from surgery. The operative time and frequency of intake of painkillers were measured. Results. The G1 and G2 groups showed a significant difference with a higher use of painkillers observed for G1. The G2 patients showed a lower level of pain (VAS) at all experimental times between 8 hours to 7 days (p<0.01) postsurgery. At 15 days, the pain levels were similar for both groups. No differences were found in site preparation duration between the study groups. Conclusions. The evidence supports the application of the piezoelectric approach compared to the drill’s osteotomy as a useful technique for implant site preparation. This trial is registered with NCT03978923.

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