Postoperative morbidity in pediatric patients following dental treatment under general anesthesia

Year 2019, Volume: 53 Issue: 3, 113 - 118, 01.10.2019

Merve Erkmen Almaz Aylin Akbay Oba Işıl Şaroğlu Sönmez

Abstract

Purpose: The aims of this study were to investigate post-operative complications in pediatric patients 24 and 72 hours after general anesthesia (GA) and to identify any associations between dental procedures and complications.
Materials and Methods: One hundred and thirty three healthy pediatric patients who had undergone dental treatment under GA (age range: two to nine years) were included in this study. The project was designed as a prospective, observational study supported by a questionnaire that collected data on children’s post-operative complaints. Preoperative data were obtained from patients’ files and included age, gender, medical condition and admission type (inpatient or outpatient) variables. The post-operative complaints were assessed either by phone contact or by face-to-face interviews using a questionnaire 24 and 72 hours after treatment.
Results: 69.9% of children reported one or more complaints after 24 hours and 35.3% after 72 hours. Coughing and pain (27.1%), inability to eat (24.8%), psychological changes (24.1%) and a sore throat (21.1%) were the most common complaints during the first day. After 72 hours, the severity and rate of the complications decreased significantly (p < 0.05).
Conclusions: Post-operative complaints following dental treatment under GA tended to be of mild severity and were mainly limited to the first day after the procedure.

Keywords

children, dental care, general anesthesia, complication, postoperative

Supporting Institution

The authors declared that this study has received no financial support.

References

• 1. Kaste LM, Selwitz RH, Oldakowski RJ, Brunelle JA, Winn DM, Brown LJ. Coronal caries in the primary and permanent dentition of children and adolescents 1-17 years of age: United States, 1988-1991. J Dent Res 1996;75:631-641.
• 2. Almaz ME, Sonmez IS, Oba AA, Alp S. Assessing changes in oral health-related quality of life following dental rehabilitation under general anesthesia. J Clin Pediatr Dent 2014;38(3):263-267.
• 3. Low W, Tan S, Schwartz S. The effect of severe caries on the quality of life in young children. Ped Dent 1999;21(6):325-326.
• 4. Jamieson WJ, Vargas K. Recall rates and caries experience of patients undergoing general anesthesia for dental treatment. Ped Dent 2007;29(3):253-257.
• 5. Jalevik B, Klingberg GA. Dental treatment, dental fear and behaviour management problems in children with severe enamel hypomineralization of their permanent first molars. Int J Ped Dent 2002;12(1):24-32.
• 6. Vinckier F, Gizani S, Declerck D. Comprehensive dental care for children with rampant caries under general anaesthesia. Int J Ped Dent 2001;11(1):25-32.
• 7. Anderson HK, Drummond BK, Thomson WM. Changes in aspects of children's oral-health-related quality of life following dental treatment under general anaesthesia. Int J Ped Dent 2004;14(5):317-325.
• 8. Malden PE, Thomson WM, Jokovic A, Locker D. Changes in parent-assessed oral health-related quality of life among young children following dental treatment under general anaesthetic. Community Dent Oral Epidemiol 2008;36(2):108-117.
• 9. Nunn JH, Davidson G, Gordon PH, Storrs J. A retrospective review of a service to provide comprehensive dental care under general anesthesia. Spec Care Dentist 1995;15(3):97-101.
• 10. Klaassen MA, Veerkamp JS, Hoogstraten J. Dental treatment under general anaesthesia: the short-term change in young children's oral-health-related quality of life. Eur Arch Paed Dent 2008;9(3):130-137.
• 11. White H, Lee JY, Vann WF, Jr. Parental evaluation of quality of life measures following pediatric dental treatment using general anesthesia. Anesthesia progress. 2003;50(3):105-110.
• 12. Krippaehne JA, Montgomery MT. Morbidity and mortality from pharmacosedation and general anesthesia in the dental office. J Oral Maxillofac Surg 1992;50(7):691-698.
• 13. Enever GR, Nunn JH, Sheehan JK. A comparison of post-operative morbidity following outpatient dental care under general anaesthesia in paediatric patients with and without disabilities. Int J Ped Dent 2000;10(2):120-125.
• 14. Holt RD, Chidiac RH, Rule DC. Dental treatment for children under general anaesthesia in day care facilities at a London dental hospital. Br Dent J 1991;170(7):262-266.
• 15. 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;19:6.
• 16. Black AE, Hatch DJ, Nauth-Misir N. Complications of nasotracheal intubation in neonates, infants and children: a review of 4 years' experience in a children's hospital. Br J Anaesth. 1990;65(4):461-467.
• 17. Atan S, Ashley P, Gilthorpe MS, Scheer B, Mason C, Roberts G. Morbidity following dental treatment of children under intubation general anaesthesia in a day-stay unit. Int J Ped Dent 2004;14(1):9-16.
• 18. Escanilla-Casal A, Ausucua-Ibanez M, Aznar-Gomez M, Viano-Garcia JM, Sentis-Vilalta J, Rivera-Baro A. Comparative study of postoperative morbidity in dental treatment under general anesthesia in pediatric patients with and without an underlying disease. Int J Ped Dent 2016;26(2):141-148.
• 19. Hosey MT, Macpherson LM, Adair P, Tochel C, Burnside G, Pine C. Dental anxiety, distress at induction and postoperative morbidity in children undergoing tooth extraction using general anaesthesia. Br Dent J. 2006;200(1):39-43.
• 20. Jensen B. Post-operative pain and pain management in children after dental extractions under general anaesthesia. Eur Arch Paed Dent 2012;13(3):119-125.
• 21. Hong JY, Oh JI, Kim SM. Comparison of sevoflurane-nitrous oxide and target-controlled propofol with fentanyl anesthesia for hysteroscopy. Yonsei Med J 2002;43(4):420-426.
• 22. Jokela RM, Kangas-Saarela TA, Valanne JV, Koivuranta MK, Ranta PO, Alahuhta SM. Postoperative nausea and vomiting after sevoflurane with or without ondansetron compared with propofol in female patients undergoing breast surgery. Anesth Analg 2000;91(5):1062-1065.
• 23. Hall CEJ, Shutt LE. Nasotracheal intubation for head and neck surgery. Anaesthesia 2003;58(3):249-256.
• 24. Prasanna D, Bhat S. Nasotracheal Intubation: An Overview. J Maxillofac Oral Surg 2014;13(4):366-372.
• 25. Divatia JV, Bhowmick K. Complications of endotracheal intubation and other airway management procedures. Indian J. Anaesth 2005;49(4):308-318.
• 26. Chia-Ling T Y-LT, Yng-Tzer L, Yai-Tin L. A retrospective study of dental treatment under general anesthesia of children with or without a chronic illness and/or a disability. Chang Gung Med J 2006;29:408-412.
• 27. Breschan C, Platzer M, Jost R, Stettner H, Likar R. Midazolam does not reduce emergence delirium after sevoflurane anesthesia in children. Paediatr Anaesth 2007;17(4):347-352.
• 28. Keaney A, Diviney D, Harte S, Lyons B. Postoperative behavioral changes following anesthesia with sevoflurane. Paediatr Anaesth 2004;14(10):866-870.
• 29. Al-Bahlani S, Sherriff A, Crawford PJ. Tooth extraction, bleeding and pain control. J R Coll Surg Edinb 2001;46(5):261-264.
• 30. Coulthard P, Rolfe S, Mackie IC, Gazal G, Morton M, Jackson-Leech D. Intraoperative local anaesthesia for paediatric postoperative oral surgery pain--a randomized controlled trial. Int J Oral Maxillofac Surg 2006;35(12):1114-1119.