Local anaesthesia with intravenous analgesia as an alternative to general anaesthesia for medically compromised patients undergoing oral surgery. A retrospective study of sixty-two cases.

The purpose of this retrospective study was to evaluate the combined use of intravenous analgesia, with a potent opiate alone, supplemented by local anaesthesia as an alternative to general anaesthesia for medically compromised patients. Sixty-two in-patients, aged between 32 and 80 years, with an ASA physical status of III and IV, were involved in this study. The local anesthetic used was 4% articain with epinephrine (1:200,000) and narcotic analgesics were Fentanyl or Alfentanil. Surgical procedures included multiple dental extractions, cystectomy and the removal of impacted teeth. All patients completed the surgery without deeper anaesthesia and mostly enjoyed a comfortable intraoperative period. Only one respiratory depression was observed, but quickly reversed. Other adverse effects were few and without consequences, hemodynamic changes remained in tolerable limits. In conclusion this anaesthetic technique can be a suitable alternative to general anaesthesia in oral surgery for high-risk patients.