Background: Postoperative pain management is challenging in patients with oral cancer, especially those undergoing reconstructive surgery. Patient-controlled analgesia (PCA) is widely used, and fentanyl (FTN) concentration adjustments may improve pain control. This study aimed to evaluate the effects of FTN PCA concentration and reconstructive surgery on postoperative pain in patients with oral cancer. Methods: This retrospective observational study analyzed 140 patients with oral cancer who underwent surgery under general anesthesia. Patients were categorized based on FTN PCA dosage (FTN 700 mcg and ketorolac 150 mg vs. FTN 1400 mcg and ketorolac 150 mg). Pain was assessed using the visual analog scale (VAS) at multiple time points postoperatively (0, 12, 24, 36, 48, 60, and 72 h). PCA usage patterns, including demand count, delivery count, and delivery/demand ratios, were compared across subgroups. Missing data were imputed using linear interpolation. Results: PCA usage and pain control were evaluated between the FTN 700 mcg (N = 40) and 1400 mcg (N = 100) groups, stratified by reconstruction status. Demographic characteristics showed no significant difference.In the reconstructive surgery subgroup, patients in the FTN 1400 mcg group showed lower PCA refill counts (1.45 ± 0.69 vs. 1.61 ± 0.58) and fewer delivery counts (17.1 ± 21.3 vs. 25.1 ± 28.5) compared to those in the FTN 700 mcg group, achieving similar or superior pain control with fewer interventions. Similarly, patients without reconstructive surgery in the FTN 1400 mcg group demonstrated lower PCA refill counts, shorter PCA usage times, and fewer delivery counts. VAS scores decreased consistently over time across all groups but remained higher in the reconstruction groups. Logistic regression analysis revealed that patients with reconstructive surgery in the FTN 1400 mcg group were more likely to achieve a VAS score of ≤ 3.0 at 72 h postoperatively (P = 0.022). These findings indicate FTN 1400 mcg’s superiority in managing postoperative pain. Conclusion Comparing FTN PCA dosages, 1400 mcg demonstrated superior pain control to 700 mcg in patients undergoing oral cancer surgery, particularly those who underwent reconstructive surgery. This finding underscores the importance of optimizing FTN dosages to enhance postoperative pain management, reduce PCA-related demands, and achieve better patient outcomes.

Background: Postoperative pain management is challenging in patients with oral cancer, especially those undergoing reconstructive surgery. Patient-controlled analgesia (PCA) is widely used, and fentanyl (FTN) concentration adjustments may improve pain control. This study aimed to evaluate the effects of FTN PCA concentration and reconstructive surgery on postoperative pain in patients with oral cancer. Methods: This retrospective observational study analyzed 140 patients with oral cancer who underwent surgery under general anesthesia. Patients were categorized based on FTN PCA dosage (FTN 700 mcg and ketorolac 150 mg vs. FTN 1400 mcg and ketorolac 150 mg). Pain was assessed using the visual analog scale (VAS) at multiple time points postoperatively (0, 12, 24, 36, 48, 60, and 72 h). PCA usage patterns, including demand count, delivery count, and delivery/demand ratios, were compared across subgroups. Missing data were imputed using linear interpolation. Results: PCA usage and pain control were evaluated between the FTN 700 mcg (N = 40) and 1400 mcg (N = 100) groups, stratified by reconstruction status. Demographic characteristics showed no significant difference.In the reconstructive surgery subgroup, patients in the FTN 1400 mcg group showed lower PCA refill counts (1.45 ± 0.69 vs. 1.61 ± 0.58) and fewer delivery counts (17.1 ± 21.3 vs. 25.1 ± 28.5) compared to those in the FTN 700 mcg group, achieving similar or superior pain control with fewer interventions. Similarly, patients without reconstructive surgery in the FTN 1400 mcg group demonstrated lower PCA refill counts, shorter PCA usage times, and fewer delivery counts. VAS scores decreased consistently over time across all groups but remained higher in the reconstruction groups. Logistic regression analysis revealed that patients with reconstructive surgery in the FTN 1400 mcg group were more likely to achieve a VAS score of ≤ 3.0 at 72 h postoperatively (P = 0.022). These findings indicate FTN 1400 mcg’s superiority in managing postoperative pain. Conclusion Comparing FTN PCA dosages, 1400 mcg demonstrated superior pain control to 700 mcg in patients undergoing oral cancer surgery, particularly those who underwent reconstructive surgery. This finding underscores the importance of optimizing FTN dosages to enhance postoperative pain management, reduce PCA-related demands, and achieve better patient outcomes.

Background: Postoperative pain management is challenging in patients with oral cancer, especially those undergoing reconstructive surgery. Patient-controlled analgesia (PCA) is widely used, and fentanyl (FTN) concentration adjustments may improve pain control. This study aimed to evaluate the effects of FTN PCA concentration and reconstructive surgery on postoperative pain in patients with oral cancer. Methods: This retrospective observational study analyzed 140 patients with oral cancer who underwent surgery under general anesthesia. Patients were categorized based on FTN PCA dosage (FTN 700 mcg and ketorolac 150 mg vs. FTN 1400 mcg and ketorolac 150 mg). Pain was assessed using the visual analog scale (VAS) at multiple time points postoperatively (0, 12, 24, 36, 48, 60, and 72 h). PCA usage patterns, including demand count, delivery count, and delivery/demand ratios, were compared across subgroups. Missing data were imputed using linear interpolation. Results: PCA usage and pain control were evaluated between the FTN 700 mcg (N = 40) and 1400 mcg (N = 100) groups, stratified by reconstruction status. Demographic characteristics showed no significant difference.In the reconstructive surgery subgroup, patients in the FTN 1400 mcg group showed lower PCA refill counts (1.45 ± 0.69 vs. 1.61 ± 0.58) and fewer delivery counts (17.1 ± 21.3 vs. 25.1 ± 28.5) compared to those in the FTN 700 mcg group, achieving similar or superior pain control with fewer interventions. Similarly, patients without reconstructive surgery in the FTN 1400 mcg group demonstrated lower PCA refill counts, shorter PCA usage times, and fewer delivery counts. VAS scores decreased consistently over time across all groups but remained higher in the reconstruction groups. Logistic regression analysis revealed that patients with reconstructive surgery in the FTN 1400 mcg group were more likely to achieve a VAS score of ≤ 3.0 at 72 h postoperatively (P = 0.022). These findings indicate FTN 1400 mcg’s superiority in managing postoperative pain. Conclusion Comparing FTN PCA dosages, 1400 mcg demonstrated superior pain control to 700 mcg in patients undergoing oral cancer surgery, particularly those who underwent reconstructive surgery. This finding underscores the importance of optimizing FTN dosages to enhance postoperative pain management, reduce PCA-related demands, and achieve better patient outcomes.

In 1986, Altemir published the first article on submental intubation as an alternative to tracheostomy for managing difficult airways. This review provides an overview of submental/submandibular intubation, covering its development, techniques, and clinical outcomes. Initially devised to address difficult airways in oral and maxillofacial surgery, the technique has since evolved. Recent advancements include focused surgical incisions, ultrasound-guided imaging, and the use of improved procedural tools like the Seldinger technique. Clinical trials have demonstrated that submental/submandibular intubation is generally more efficient and quicker than tracheostomy in trauma patients. One of its key advantages is the absence of visible scarring, along with a less invasive recovery process. However, the technique has some limitations, including risks of infection, bleeding, and scarring, which require further investigation to optimize its application. While submental/submandibular intubation remains a valuable method for managing difficult airways, ongoing refinement and evaluation are necessary to maximize its clinical utility. This technique presents an excellent alternative in specific surgical scenarios and offers a simplified solution where other intubation methods may be unfeasible.

In 1986, Altemir published the first article on submental intubation as an alternative to tracheostomy for managing difficult airways. This review provides an overview of submental/submandibular intubation, covering its development, techniques, and clinical outcomes. Initially devised to address difficult airways in oral and maxillofacial surgery, the technique has since evolved. Recent advancements include focused surgical incisions, ultrasound-guided imaging, and the use of improved procedural tools like the Seldinger technique. Clinical trials have demonstrated that submental/submandibular intubation is generally more efficient and quicker than tracheostomy in trauma patients. One of its key advantages is the absence of visible scarring, along with a less invasive recovery process. However, the technique has some limitations, including risks of infection, bleeding, and scarring, which require further investigation to optimize its application. While submental/submandibular intubation remains a valuable method for managing difficult airways, ongoing refinement and evaluation are necessary to maximize its clinical utility. This technique presents an excellent alternative in specific surgical scenarios and offers a simplified solution where other intubation methods may be unfeasible.

In 1986, Altemir published the first article on submental intubation as an alternative to tracheostomy for managing difficult airways. This review provides an overview of submental/submandibular intubation, covering its development, techniques, and clinical outcomes. Initially devised to address difficult airways in oral and maxillofacial surgery, the technique has since evolved. Recent advancements include focused surgical incisions, ultrasound-guided imaging, and the use of improved procedural tools like the Seldinger technique. Clinical trials have demonstrated that submental/submandibular intubation is generally more efficient and quicker than tracheostomy in trauma patients. One of its key advantages is the absence of visible scarring, along with a less invasive recovery process. However, the technique has some limitations, including risks of infection, bleeding, and scarring, which require further investigation to optimize its application. While submental/submandibular intubation remains a valuable method for managing difficult airways, ongoing refinement and evaluation are necessary to maximize its clinical utility. This technique presents an excellent alternative in specific surgical scenarios and offers a simplified solution where other intubation methods may be unfeasible.

In 1986, Altemir published the first article on submental intubation as an alternative to tracheostomy for managing difficult airways. This review provides an overview of submental/submandibular intubation, covering its development, techniques, and clinical outcomes. Initially devised to address difficult airways in oral and maxillofacial surgery, the technique has since evolved. Recent advancements include focused surgical incisions, ultrasound-guided imaging, and the use of improved procedural tools like the Seldinger technique. Clinical trials have demonstrated that submental/submandibular intubation is generally more efficient and quicker than tracheostomy in trauma patients. One of its key advantages is the absence of visible scarring, along with a less invasive recovery process. However, the technique has some limitations, including risks of infection, bleeding, and scarring, which require further investigation to optimize its application. While submental/submandibular intubation remains a valuable method for managing difficult airways, ongoing refinement and evaluation are necessary to maximize its clinical utility. This technique presents an excellent alternative in specific surgical scenarios and offers a simplified solution where other intubation methods may be unfeasible.

In 1986, Altemir published the first article on submental intubation as an alternative to tracheostomy for managing difficult airways. This review provides an overview of submental/submandibular intubation, covering its development, techniques, and clinical outcomes. Initially devised to address difficult airways in oral and maxillofacial surgery, the technique has since evolved. Recent advancements include focused surgical incisions, ultrasound-guided imaging, and the use of improved procedural tools like the Seldinger technique. Clinical trials have demonstrated that submental/submandibular intubation is generally more efficient and quicker than tracheostomy in trauma patients. One of its key advantages is the absence of visible scarring, along with a less invasive recovery process. However, the technique has some limitations, including risks of infection, bleeding, and scarring, which require further investigation to optimize its application. While submental/submandibular intubation remains a valuable method for managing difficult airways, ongoing refinement and evaluation are necessary to maximize its clinical utility. This technique presents an excellent alternative in specific surgical scenarios and offers a simplified solution where other intubation methods may be unfeasible.

Dental sedation plays a pivotal role in alleviating patient anxiety during various procedures. Remimazolam, a benzodiazepine derivative, stands out for its distinctive attributes, particularly its rapid onset of sedation coupled with a brief duration, making it an invaluable option for dental applications. The patient was admitted for the extraction of impacted third molars via patient-controlled sedation and not only demonstrated stable vital signs but also expressed a high level of satisfaction with the procedure. An in-depth analysis of plasma remimazolam concentrations and changes in the Patient State Index revealed negative correlation patterns, highlighting the inherent potential of remimazolam in achieving effective sedation. This expanded research scope aims to provide a more nuanced understanding of the pharmacological responses to remimazolam in dental sedation scenarios.This case report offers valuable insights into the evolving landscape of dental sedation methodologies and paves the way for a more informed and evidence-based approach to the use of remimazolam in patient-controlled sedation.

The video laryngoscope is a novel instrument for intubation that enables indirect visualization of the upper airway. It is recognized for its ability to enhance Cormack-Lehane grades in the management of difficult airways.Notably, video laryngoscopy is associated with equal or higher rates of intubation success within a shorter time frame than direct laryngoscopy.Video laryngoscopy facilitates faster and easier visualization of the glottis and reduces the need for Magill forceps, thereby shortening the intubation time. Despite the advanced glottic visualization afforded by video laryngoscopy, nasotracheal tube insertion and advancement occasionally fail. This is particularly evident during nasotracheal intubation, where oropharyngeal blood or secretions may obstruct the visual field on the monitor, thereby complicating video laryngoscopy. Moreover, the use of Magill forceps is markedly challenging or nearly unfeasible in this context, especially in pediatric cases. Furthermore, the substantial blade size of video laryngoscopes may restrict their applicability in individuals with limited oral apertures.This study aimed to review the literature on video laryngoscopy, discuss its clinical role in nasotracheal intubation, and address the challenges that anesthesiologists may encounter during the intubation process.