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Overnight hospital stay and/or extended recovery period may allow long-duration oral and maxillofacial surgeries in the operating room of a dental hospital in an outpatient setting: a single-center experience

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Uzumcugil Filiz, Yilbas Aysun Ankay, Akca Basak, Ozkaragoz Demet Basak, Adiloglu Selen, Tuz Hifzi Hakan, Kanbak Meral,
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 ( Uzumcugil Filiz ) - Hacettepe University School of Medicine Department of Anesthesiology and Reanimation
 ( Yilbas Aysun Ankay ) - Hacettepe University School of Medicine Department of Anesthesiology and Reanimation
 ( Akca Basak ) - Hacettepe University School of Medicine Department of Anesthesiology and Reanimation
 ( Ozkaragoz Demet Basak ) - Hacettepe University School of Medicine Department of Anesthesiology and Reanimation
 ( Adiloglu Selen ) - Hacettepe University Faculty of Dentistry Department of Oral and Maxillofacial Surgery
 ( Tuz Hifzi Hakan ) - Hacettepe University Faculty of Dentistry Department of Oral and Maxillofacial Surgery
 ( Kanbak Meral ) - Hacettepe University School of Medicine Department of Anesthesiology and Reanimation

Abstract


Objectives: The requirement for overnight hospital stay should be considered preoperatively according to patient-related factors, type of surgery, and anesthetic management plan. In this study, we aimed to define the major factors that influence consideration of overnight hospital stay in patients undergoing oral and maxillofacial (OMF) surgery in an operating room (OR) of a dental hospital in an outpatient setting.

Materials and Methods: The records of patients who underwent oral procedures under general anesthesia between 2014-2017 were reviewed.

Results: A total of 821 patients underwent oral procedures under general anesthesia; 631 of them underwent OMF surgery in the OR of a dental hospital, and 174 of these patients were hospitalized for overnight stay. There was no significant difference in the number of patients with comorbidities between the outpatient and hospitalized patient groups (P=0.389). The duration of surgery was longer in the hospitalized patient group (105.25¡¾57.48 vs 189.62¡¾82.03 minutes; P<0.001). Double-jaw (n=15; 310.00¡¾54.21 minutes) and iliac crest grafting surgeries (n=59; 211.86¡¾61.02 minutes) had the longest durations. Patients who underwent iliac crest grafting had the highest rates of hospitalization (79%). The overall recovery period was longer in outpatients (119.40¡¾41.60 vs 149.83¡¾52.04; P<0.001).

Conclusion: Duration of surgery was the main determinant in considering whether a patient required overnight hospital stay. However, patients with an American Society of Anesthesiology physical status score <3 may be scheduled for OMF surgery in the OR of a dental hospital in an outpatient setting regardless of duration of surgery if overnight hospital stay is planned or an extended recovery period is provided until patients meet the discharge criteria.

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Anesthesia; Inpatients; Oral and maxillofacial surgery; Outpatients

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