Pilot study in France about the infiltration of local anaesthetics associated to oral surgery procedures performed under general anaesthesia

Abstract

Introduction: Opinions differ regarding the combined use of local anaesthesia (LA) and general anaesthesia (GA) in oral surgery procedures. The aim of this study was to evaluate practices in France concerning intraoperative LA for oral surgery performed under GA. Practitioners and method: We conducted a prospective survey of 250 oral surgery practitioners (CNIL-2045135v0 e) and carried out a literature review with the MEDLINE search engine (PubMed) covering the period from January 2000 to September 2017. Results: Among the 77 practitioners who participated, 88.3% were dental practitioners, the majority of whom were in the 25–34-yr age group. More than half (59%) infiltrated the surgical site; 46% pre-operatively, 24% intraoperatively and 11% post-operatively. Discussion: LA under GA appears to have advantages for post-operative pain management, dissection of the first mucosal plane and bleeding management pre- and post-operatively. The contraindications remain the same as for patients in a vigilant state. In children, it should be used in moderation to limit the risk of self-inflicted lip or mouth trauma during recovery. Conclusion: The indications of LA under GA are operator-dependent and the analysis of the literature did not allow us to determine the interest or not of LA administered intraoperatively during oral surgery performed under GA.

Keywords

• local anaesthesia
• general anaesthesia
• oral surgery