Evaluation of Postoperative Comfort and Parental Satisfaction in Children Following Dental Treatment under General Anesthesia

Abstract

ABSTRACT Objective: The aim of this study is to examine dental treatments performed under general anesthesia (DTGA) in children and to evaluate the comfort level and parental satisfaction in the postoperative period. Material and Methods: Forty-eight children aged between 3-13 years who received DTGA and their parents were included in the study. Data about patient’s age, ASA classification, operation time, biochemical values, current complaints and diseases, medication used, presence of complications, and treatment were recorded. After the dental operation, a 26-question survey including their overall satisfaction with the DTGA, the problems they experienced before and their changes after the DTGA, and the stage they experienced after the treatment. Kruskal-Wallis, χ2, and Fischer’s exact tests were used for statistical analyses. Results: The mean age of the patients (years), the duration of the operation (minutes), and the number of filling and extraction treatments (units) were found to be 7.35±2.63 years, 76.9±22.1 minutes, and 8.18±4.19 units, respectively. According to the survey data, it was determined that the parents were generally satisfied with the DTGA (97%) and would have it done again in case of necessary (100%). No statistically significant difference was observed between healthy children and children with special treatment needs (STN) regarding satisfaction, (p=0.688). No significant relationships were detected in satisfaction and postoperative pain complaints regarding the number of treatments being less (≤6) or more (>6), (p=0.727; p=0.425, respectively). Conclusion: According to the results of this study, levels of postoperative comfort and parental satisfaction were found to be high in children who received DTGA. It is concluded that DTGA is a safe and preferable method for healthy children or children with STN.

Keywords

• Parental satisfaction
• dental treatment
• general anesthesia
• postoperative comfort
• child

Çocuklarda Genel Anestezi Altında Uygulanan Dental Tedavilerde Postoperatif Konfor ve Veli Memnuniyetinin Değerlendirilmesi

Abstract

Amaç: Bu çalışmanın amacı, çocuk hastalarda genel anestezi (GA) altında yapılan diş tedavilerinin incelenmesi, postoperatif dönemdeki konfor düzeyi ve ebeveyn memnuniyetinin değerlendirilmesidir. Gereç ve Yöntemler: GA altında dental tedavisi yapılan 3-13 yaş grubu 48 çocuk hasta ve velisi çalışma kapsamına alınmıştır. Hastaların yaş, cinsiyet, Amerikan Anesteziyoloji Derneği’nin (American Society of Anesthesiologists–ASA) Fiziksel Durum Sınıflandırma Sistemi, operasyon süresi, biyokimyasal değerleri, mevcut şikâyet ve hastalıkları, kullanılan ilaçlar, komplikasyon varlığı ve uygulanan tedavi verileri kaydedilmiştir. Dental operasyonun ardından, velilere GA süreciyle ilgili memnuniyet düzeyi, anestezi öncesinde yaşadıkları zorluklar ve tedavi sonrası süreçlerini değerlendiren 26 soruluk bir anket uygulanmıştır. Verilerin istatistiksel analizleri için Ki-kare, Kruskal-Wallis ve Fischer’in kesin testi kullanılmıştır. Bulgular: Hastaların ortalama yaş ortalaması (yıl), operasyon süresi (dakika) ve uygulanan dolgu ve çekim tedavisinin sayısı (adet) sırasıyla 7,35±2,63 yıl; 76,9±22,1 dakika ve 8,18±4,19 adet olarak bulunmuştur. Anket sonuçları incelendiğinde velilerin genel olarak GA ile diş tedavisi işleminden memnun kaldığı (%97), ihtiyaç duyulduğu takdirde GA ile yeniden tedavi yaptıracakları (%100) tespit edilmiştir. Sağlıklı ve özel sağlık gereksinimi (ÖSG) olan çocukların tedaviden sonraki memnuniyet değerlendirmeleri arasında istatistiksel olarak anlamlı fark gözlenmemiştir (p=0,688). Tedavi sayısının az (≤6) veya çok (>6) olması ile operasyon sonrası ağrı şikâyeti ve memnuniyet durumu arasında anlamlı bir ilişki saptanmamıştır (sırasıyla; p=0,727; p=0,425). Sonuç: Bu çalışmanın sonuçlarına göre, GA altında diş tedavisi yapılan çocuklarda postoperatif konfor ve ebeveyn memnuniyet düzeyi yüksek olarak bulunmuştur. Sağlıklı veya ÖSG bulunan çocukların diş tedavilerinin GA altında yapılmasının, güvenli ve tercih edilebilir bir yöntem olduğu sonucuna varılmıştır.

Keywords

• ebeveyn memnuniyeti
• genel anestezi
• dental tedavi
• postoperatif konfor
• çocuk

References

1. 1. Dentistry AAoP. Clinical guideline on the elective use of minimal, moderate, and deep sedation and general anesthesia for pediatric dental patients. Pediatric Dentistry. 2004;26:95.
2. 2- Jankauskiene B, Virtanen JI, Kubilius R, Narbutaite J. Oral health related quality of life after dental general anaesthesia treatment among children: a follow-up study. BMC Oral Health. 2014;14:81.
3. 3- Baghdadi ZD. Children’s oral health-related quality of life and associated factors: Midterm changes after dental treatment under general anesthesia. Journal of Clinical and Experimental Dentistry. 2015;1(7):106–13.
4. 4- Farsi N, Ba’akdah R, Boker A, Almushayt A. Postoperative complications of pediatric dental general anesthesia procedure provided in Jeddah hospitals, Saudi Arabia. BMC Oral Health. 2009;9:1-9.
5. 5- Eshghi A, Samani MJ, Najafi NF, Hajiahmadi M. Evaluation of efficacy of restorative dental treatment provided under general anesthesia at hospitalized pediatric dental patients of Isfahan. Dental Research Journal (Isfahan). 2012;9(4):478-82.
6. 6- El Batawi HY, Panigrahi P, Awad MA. Perceived outcomes and satisfaction of Saudi parents and their children following dental rehabilitation under general anesthesia: A 2-year follow-up. Journal of International Society of Preventive and Community Dentistry. 2014;4(Suppl 3):S153-60.
7. 7- Špiljak, B., Brailo, V., Janković, B., Gabrić, D., Lozić, M., Stambolija, V., Vidović Juras, D., Karlović, Z., & Verzak, Ž. (2022). Satisfaction of Parents and Caregivers with Dental Treatment of Children Under General Anesthesia in a Day Care Surgery Setting. Acta stomatologica Croatica, 56(4), 376–386.
8. 8- Cantekin K, Yildirim MD, Delikan E, Çetin S. Postoperative discomfort of dental rehabilitation under general anesthesia. Pakistan Journal of Medical Science 2014;30(4):784-788.

9. 9- Bahramian A, Abbasi T, Negahdari R, Mahmoudreza A, Fatemeh N, Bahramian M, et al. Evaluation of Parental Satisfaction and Expectation from Dental Care Services of Children and Adults Under General Anesthesia in Tabriz Dental School Hospital in 2017. International Journal of Scientific Research and Innovative Technology. 2018; 5(1):82-91.
10. 10- American Academy of Pediatric Dentistry. Behavior guidance for the pediatric dental patient. The Reference Manual of Pediatric Dentistry. Chicago, Ill.: American Academy of Pediatric Dentistry; 2024:358-78.
11. 11- Boukhobza S, Stamm T, Glatthor J, Meißner N, Bekes K. Changes in oral health-related quality of life among Austrian preschool children following dental treatment under general anaesthesia. Clinical Oral Investigation. 2021;25(5):2821-6.
12. 12- Anderson, H. K., Drummond, B. K., & Thomson, W. M. (2004). Changes in aspects of children's oral-health-related quality of life following dental treatment under general anaesthesia. International Journal of Peadiatric Dentistry, 14(5), 317–325.
13. 13- Ghafournia M, Eshghi A, Mosleh H, Iranmanesh P. Complications after dental rehabilitation under general anesthesia in Isfahan during February to May 2016. Dental Research Journal (Isfahan). 2021;18:53.
14. 14- Lone PA, Wani NA, Ain QU, Heer A, Devi R, Mahajan S. Common postoperative complications after general anesthesia in oral and maxillofacial surgery. National Journal of Maxillofacial Surgery. 2021;12(2):206-210.
15. 15- Randrianarivony, J., Ravelomanantsoa, J.J. & Razanamihaja, N. Evaluation of the reliability and validity of the Early Childhood Oral Health Impact Scale (ECOHIS) questionnaire translated into Malagasy. Health and Quality Life Outcomes. 2020 ;18(1):39.
16. 16- Ohtawa Y, Yoshida M, Fukuda K. Parental Satisfaction with Ambulatory Anesthesia during Dental Treatment for Disabled Individuals and Their Preference for Same in Future. Bulletin of Tokyo Dental College. 2019;60(1):53-60.
17. 17- Abdelgawad, F., & Wassef, N.M. Parental satisfaction after children's dental rehabilitation under general anesthesia. Tanta Dental Journal. 2019;16:197-200.
18. 18- Almaz ME, Oba AA, Sonmez IS. Postoperative morbidityin pediatric patients following dental treatment under general anesthesia. European Oral Research. 2019;53:113.
19. 19- Versloot J, Veerkamp JS, Hoogstraten J. Dental Discomfort Questionnaire: assessment of dental discomfort and/or pain in very young children. Community Dentistry and Oral Epidemiology. 2006;34(1):47-52.
20. 20- Demir P, Duman S, Akdağ U, Saraç O, Duruk G. Genel anestezi altında diş tedavisi sonrası hastaların postoperatif konforunun değerlendirilmesi. Necmettin Erbakan University Dental Journal. 2021;1:7-13.
21. 21- Hong JY, Oh JI, Kim SM. Comparison of sevoflurane-nitrous oxide and target-controlled propofol with fentanyl anesthesia for hysteroscopy. Yonsei Medical Journal. 2002;43:420-6.
22. 22- Needleman HL, Harpavat S, Wu S, Allred EN, Berde C. Postoperative pain and other sequelae of dental rehabilitations performed on children under general anesthesia. Pediatric Dentistry. 2008;30:111-21.
23. 23- Hu Y-H, Tsai A, Ou-Yang L-W, Chuang L-C, Chang P-C. Postoperative dental morbidity in children following dental treatment under general anesthesia. BMC Oral Health. 2018;18:84.
24. 24- Public Health England. Delivering Better Oral Health : An Evidence- Based Tool kit for Prevention. 2014.