ASSESSMENT OF PERIOPERATIVE COMPLICATIONS AMONG PATIENTS UNDERGOING DENTAL AND ORAL SURGICAL PROCEDURES UNDER GENERAL ANESTHESIAA Hospital-Based Descriptive Observational Study at Khyber College of Dentistry Hospital, Peshawar

Abstract

Background: General anesthesia is frequently used for extensive dental and oral surgical procedures when conventional behavioral management, local anesthesia, or conscious sedation is inadequate. Although general anesthesia provides controlled operating conditions, patients may experience postoperative complications including pain, nausea, vomiting, sore throat, cough, bleeding, drowsiness, and difficulty eating. This study assessed the frequency and pattern of perioperative complications among patients undergoing dental and oral surgical procedures under general anesthesia and examined selected demographic, anesthetic, and procedural factors associated with postoperative complications. Methods: A hospital-based descriptive observational study was conducted at Khyber College of Dentistry Hospital, Peshawar, from January 2025 to June 2025. A total of 150 patients who underwent elective dental and oral surgical procedures under general anesthesia were included. Demographic characteristics, American Society of Anesthesiologists (ASA) physical status, procedure type, duration of surgery, duration of anesthesia, and postoperative complications were recorded. Patients were assessed in the recovery area and at 24 and 72 hours after surgery. Data were analyzed using IBM SPSS Statistics. Results: Of the 150 patients, 86 (57.3%) experienced at least one postoperative complication. Postoperative pain was the most frequently reported complication, occurring in 52 (34.7%) patients, followed by nausea/vomiting in 29 (19.3%), sore throat in 24 (16.0%), drowsiness in 22 (14.7%), postoperative bleeding in 18 (12.0%), and cough or respiratory symptoms in 15 (10.0%). Transient oxygen desaturation occurred in 7 (4.7%) patients and hypotension in 5 (3.3%). Complications were significantly more frequent with longer anesthesia duration (p = 0.004), and anesthesia duration >120 minutes (adjusted OR 2.81; 95% CI 1.35–5.85) and surgery duration >120 minutes (adjusted OR 2.47; 95% CI 1.18–5.17) were independent predictors. Complications were numerically more frequent among ASA II/III patients (68.9% vs. 52.4%), but the difference was not statistically significant (p = 0.061). Conclusion: Minor postoperative complications were common after dental and oral surgical procedures under general anesthesia at this center, whereas serious complications were uncommon. Longer anesthesia and surgical duration were associated with a higher risk of complications. Appropriate preoperative assessment, intraoperative monitoring, effective postoperative analgesia, prevention and treatment of nausea and vomiting, and adequate recovery-room observation remain important for patient safety.

Keywords: General anesthesia; Dental surgery; Oral surgery; Perioperative complications; Postoperative pain; Nausea and vomiting; Patient safety; Anesthesia.