Task of Local Anaesthesia in Major Maxillofacial Surgical Operations (A 36 Case Series Operated in Al-Salam Teaching Hospital)

Oral and maxillofacial surgery is that specialty of dentistry including the diagnosis as well as surgical and adjunctive treatment of diseases, injuries, and defects, including both the functional and esthetic aspects of hard and soft tissues of oral and maxillofacial region. Local anesthesia (LA) also has role in maxillofacial surgeries, some oral and maxillofacial surgical procedures can, however, be performed, with or without conscious sedation depending on the extent of the lesion and the ease of surgical access. We aim in this article to high lighting role of local anesthesia for surgical management of major maxillofacial operations already planned to be operated under general anaesthesia. Sample presentation of major maxillofacial cases that can be underwent under local anesthesia also patients evaluation regarding pain and wound healing. Case series of 36 patients (5-78) years old, from (2004-2013) attained Maxillofacial department at Al-Salam (Mosul) and Al-Kadhimiya (Baghdad) Teaching Hospital. All patients underwent major surgeries under local anesthesia (5-7 cartridges). Patients evaluated regarding pain, wound healing and recovery period. Five patients had moderate intraoperative pain that forced us to increase the dose of local anesthesia, minimal blood ooze one hour postoperatively; healing process was uncomplicated. In accordance to time need for each surgery half of cases need no more than 30 minutes to complete the surgery. More than half of patients (27.77% -33.33%) recommend 4-5 cartridge of local anesthesia uses to complete the surgeries. Oral and Maxillofacial operations which can be managed under local anesthesia are practicable and were tolerated and accepted by the adult patients. Local anesthesia can be used to facilitate safer and more efficient procedures especially in medically compromised patients. Local anesthesia surgeries alleviate risk factors and laryngeal discomfort associated with surgeries under general anesthesia, no starvation and minimal hospital stay.