Third molar surgery outcomes: a comparison between intravenous sedation and general anaesthesia

Abstract

Objective. To compare intravenous (IV) sedation and general anaesthesia (GA) for third molar surgery in terms of patient anxiety, satisfaction, choice and, oral-health-related quality-of-life (OHRQoL).

Study Design. A quasi-experimental design was used, with a clinical convenience sample of patients requiring the removal of two mandibular third molar teeth. Each participant was consulted by an oral and maxillofacial surgeon or one of their surgical trainees, and they were given a free choice between IV sedation and GA for their operation. Participants completed a questionnaire before surgery and again 10-14 days afterwards. Data collected before surgery included baseline sociodemographic characteristics, OHRQoL, anxiety, aspects of personality (positive and negative emotionality) and history of pain. Data collected after surgery included the severity of pain, time taken for recovery, OHRQoL, anxiety, and satisfaction with the surgery.

Results. Of the 142 patients, 73 (51.4%) chose to have the operation under IV sedation and 69 (49.4%) underwent GA. Patients opting for GA scored more highly at baseline on negative affectivity and dental anxiety. After surgery, they reported taking more days off before returning to normal activities, as well as a higher incidence of sore throat and nausea.

Conclusion. Patients with negative affectivity and higher anxiety opt for their operation to be carried out under GA but this results in more post-operative side-effects and days off.