Differences in Speed of Recovery From Anesthesia for Intraoral Surgery

The goal of this clinical trial is to compare two groups of patients going in general anesthesia for intraoral surgery, the first group TIVA with propofol and the second group inhalational with sevoflurane. The main questions it aims to answer are to asses speed and quality of recovery from general anesthesia. Participants will fill out a questionnaire to evaluate the quality of recovery from anesthesia using the QoR-40 1h, 24h, and 30 days after waking up from anesthesia in comparison to the results of the same questionnaire before surgery. Also, the investigators will perform a hand grip and bite strength test on the patients after waking up from anesthesia in the operating room, after 1 hour in the recovery room, and after 24 hours compared to preoperative values. The investigators will compare TIVA and Volatile groups to see if there are any differences in recovery seed, muscle strength recovery, postoperative nausea and vomiting, and shivering between groups.

Sex

All

Minimum age

18 Years

Criteria for patient inclusion are:

* patients older than 18 years
* ASA status 1-2,
* Patients who have an indication for an intraoral surgical procedure longer than 30 minutes.
* Surgical interventions on the soft tissues of the mouth, intraoral excision of tumors, operated through the transoral route
* Patients who agreed to the research and signed the consent

The exclusion criteria are:

* ASA status 3 and higher,
* The need for postoperative care in the ICU,
* Surgery lasting more than 2 hours,
* Surgical procedures that in the operative plan include injuries to the grip of the masticatory muscles, the masticatory muscles themselves, and procedures on the bone, and thus may result in a difference in the strength of the bite. Masticatory muscles are defined as musculus pterygoideus lateralis, musculus pterygoideus medialis, musculus temporalis and musculus masseter.
* Surgical procedures on the bone where the bite force test alone could cause injury
* Patients with diseases of the neuromuscular junction and muscle diseases, myopathy, dystrophy
* Patients taking medications that can cause myopathy or muscle weakness
* Known allergies to drugs used in the trial,
* Refusing to participate

• BACKGROUNDDiniz JA, Siqueira ADS, Araujo GM, Faro TF, Torres LHS, Oliveira E Silva ED, Laureano Filho JR. Intraoral Approach for Surgical Treatment of Psammomatoid Juvenile Ossifying Fibroma. J Craniofac Surg. 2020 May/Jun;31(3):e306-e309. doi: 10.1097/SCS.0000000000006171. PMID 31934971
• BACKGROUNDFerreira, C. C., Pereira, M. B. F., Bruzinga, F. F. B., Castro, H. H. O., Souto, G. R., Souza, P. E. A., & De Oliveira, L. J. (2022, September). AN UNUSUAL INTRAORAL LIPOMA: A CASE REPORT. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 134(3), e119. https://doi.org/10.1016/j.oooo.2022.01.212
• BACKGROUNDFrerich, B. (2020). Complications in Maxillofacial Tumor Surgery. Complications in Cranio-Maxillofacial and Oral Surgery, 253-277. https://doi.org/10.1007/978-3-030-40150-4_13
• BACKGROUNDTamunobelema, D. M. S., & Uruaka, C. I. (2023, March 11). General Anaesthetic Agents and its Implication on the Cardiovascular System: A Systemic Review. Saudi Journal of Medical and Pharmaceutical Sciences, 9(03), 171-183. https://doi.org/10.36348/sjmps.2023.v09i03.006
• BACKGROUNDQurbani, B., & Karim, S. B. (2022, December 29). Comparison among complications of common intravenous anesthetic drugs during general anesthesia for patients undergoing surgery in Sulaimani city. Annals of the College of Medicine, Mosul, 44(2), 159-165. https://doi.org/10.33899/mmed.2022.136178.1166
• BACKGROUNDFiorda-Diaz, J., Stoicea, N., & Bergese, S. (2017). Anesthetic Agents. Essentials of Neuroanesthesia, 123-129. https://doi.org/10.1016/b978-0-12-805299-0.00007-5
• BACKGROUNDHao X, Ou M, Zhang D, Zhao W, Yang Y, Liu J, Yang H, Zhu T, Li Y, Zhou C. The Effects of General Anesthetics on Synaptic Transmission. Curr Neuropharmacol. 2020;18(10):936-965. doi: 10.2174/1570159X18666200227125854. PMID 32106800
• BACKGROUNDMonisha, B., Madhusudhana, R., & Sujatha, M. (2023). Effects of Isoflurane versus Propofol for Postoperative Neurocognitive Recovery in Patients Undergoing Surgery under General Anaesthesia: A Randomised Clinical Study. JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH. https://doi.org/10.7860/jcdr/2023/62147.17888