Evaluation of Advanced Behavior Guidance Techniques Used in Dentistry: Sedation and General Anesthesia

Year 2020, Volume: 42 Issue: 5, 466 - 473, 15.09.2020

Hande G. Aytuluk

https://doi.org/10.20515/otd.725531

Abstract

Although most of the dental procedures can be held in the office setting, sedation or general anesthesia is required in some of the patients. The aim of this study was to review patients who underwent dental procedures under anesthesia with the emphasis on patient characteristics, procedural and anesthetic properties, and to consider this issue from various aspects. Medical records of 362 patients who underwent dental procedures under sedation or general anesthesia were analyzed. Demographic data, the reasons for treatment under anesthesia, anesthetic, and procedural characteristics were recorded. Patients were evaluated under three groups according to their ages (<10years: children; n=159, 10-24 years: young people; n=113, ≥25 years; n=90: adults). Noncompliance was the main reason for dental surgery under anesthesia in children (76.1%) and young people (41.6%). Mental retardation (26.7%) and extreme dental phobia (24.4%) were found to be the most frequent reasons for dental surgery under anesthesia in adults. For the reversal of rocuronium, while neostigmine was the primary choice in pediatric patients, sugammadex was the most preferred reversal agent in adults. Patients undergoing dental procedures under anesthesia constitute a specialized patient group (e.g. pediatric patients and patients with special needs). Therefore, implementing nonsurgical interventions and postponing elective surgeries to an appropriate time must be taken into consideration. For the safety and the quality of the dental procedure, the choice of anesthesia technique must be made according to the risk and benefit analysis.

Keywords

anesthetics, child, dental anesthesia, general anesthesia, outpatients

Diş Hekimliğinde Kullanılan İleri Davranış Yönlendirme Tekniklerinin Değerlendirilmesi: Sedasyon ve Genel Anestezi

Abstract

Dental işlemlerin çoğu ofis ortamında yapılabilmesine rağmen, bazı hastalarda sedasyon veya genel anestezi gereklidir. Bu çalışmanın amacı, anestezi altında dental prosedür uygulanan hastaları hasta özellikleri, işlemsel ve anestezi özellikleri vurgulanarak gözden geçirmek ve bu konuyu farklı açılardan ele almaktır. Sedasyon veya genel anestezi altında dental prosedür uygulanan 362 hastanın tıbbi kayıtları incelendi. Demografik veriler, anestezi altında tedavi nedenleri, anestezi ve prosedür özellikleri kaydedildi. Hastalar yaşlarına göre üç grup altında değerlendirildi (<10 yaş: çocuklar; n = 159, 10-24 yaş: gençler; n = 113, ≥25 yaş; n = 90: yetişkinler). Çocuklarda (76.1%) ve gençlerde (41.6%) anestezi altında diş cerrahisinin temel nedeni uyumsuzluktu. Mental retardasyon (26.7%) ve aşırı diş fobisi (24.4%) yetişkinlerde anestezi altında diş cerrahisinin en sık nedenleri olarak bulundu. Roküronyumun geri çevrilmesi için çocuk hastalarda neostigmin birincil seçenek iken, sugammadeks yetişkinlerde en çok tercih edilen ilaçtı. Anestezi altında diş tedavisi gören hastalar özel bir hasta grubu oluşturmaktadır (örneğin pediyatrik hastalar ve özel ihtiyaçları olan hastalar). Bu nedenle cerrahi olmayan müdahalelerin uygulanması ve elektif ameliyatların uygun bir zamana ertelenmesi dikkate alınmalıdır. Dental prosedürün güvenliği ve kalitesi için, risk ve fayda analizine göre anestezi tekniği seçimi yapılmalıdır.

Keywords

anestezikler, ayaktan hastalar, çocuk;, dental anestezi, genel anestezi

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