title: Outpatient third molar surgery under local anaesthesia and conscious sedation using patient-controlled analgesia with alfentanil.
abstract: We examined the feasibility of intraoperative conscious sedation employing patient-controlled analgesia with alfentanil (PCA-alfentanil) in 20 adult outpatients undergoing third molar surgery under local anaesthesia. A loading dose of intravenous alfentanil 15 mg/kg was administered immediately before local anaesthetic administration using 2% lignocaine with 1:80,000 adrenaline. This was followed by a background alfentanil infusion of 0.05 mg/kg/min. On demand alfentanil doses were 4 mg/kg with lockout intervals of 3 minutes. All patients were mildly sedated, easily aroused verbally and co-operative throughout the surgery. None experienced any cardiovascular or respiratory complications related to PCA-alfentanil. Immediate postoperative complications included nausea, vomiting and pruritus. High patient comfort and acceptance scores suggest that the use of PCA-alfentanil can be a useful adjunct to local anaesthesia in adult outpatients undergoing third molar surgery.
authors.affiliation: Department of Oral & Maxillofacial Surgery, National University of Singapore, Singapore. kmsim@pacific.net.sg
authors.forename: B T
authors.initials: BT
authors.lastname: Goh
authors.forename: K M
authors.initials: KM
authors.lastname: Sim
authors.forename: M L
authors.initials: ML
authors.lastname: Marzella
mesh_terms: D000328:Adult; D015760:Alfentanil / Q000008:administration & dosage*; D016058:Analgesia, Patient-Controlled; D000766:Anesthesia, Dental / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D016292:Procedural Sedation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008964:Molar, Third / Q000601:surgery*; D010865:Pilot Projects; D014081:Tooth Extraction
chemical_list: D018686:Anesthetics, Intravenous; D015760:Alfentanil