ANESTHETIC RISKS IN GENERAL ANESTHESIA PRACTICES IN PEDIATRIC DENTISTRY: A RETROSPECTIVE STUDY

Year 2023, Volume: 10 Issue: 4, 230 - 234, 15.06.2023

Funda Arun

https://doi.org/10.15311/selcukdentj.1230411

Abstract

Amaç
Genel anestezi (GA) altında dental tedavi uygulanan çocuk hastalarda anesteziye bağlı komplikasyonları değerlendirmeyi amaçladık.
Gereç ve Yöntem
Etik kurul onayı alındıktan sonra Selçuk Üniversitesi Diş Hekimliği Fakültesi Genel Anestezi ve Sedasyon Kliniği’nde 01.09.2020-01.09.2022 tarihleri arasında opere edilen çocuk hastaların kayıtları demografik veriler, ASA, komorbiditeler, anestezi süresi, derlenme süresi, kardiyak/ pulmoner komplikasyonlar ve beklenmeyen hastaneye yatış oranı. Hastalar yaşa göre grup 1 (0-3 yıl), grup 2 (3-6 yıl), grup 3 (>6 yıl) olarak 3 gruba ayrıldı.
Bulgular
Toplam hasta sayısı 398’di. Tüm hastalar 2-15 yaş arasındaydı. Grup 1'deki hasta sayısı 7 olduğu için karşılaştırmalarda istatistiksel olarak değerlendirilmemiştir. Tüm hastaların ortalama anestezi süresi 96.9 dakika, grup 2 ve grup 3'teki süreler sırasıyla 100,3 dakika ve 88.7 dakikaydı ve grup 2 ile 3 arasındaki fark istatistiksel olarak anlamlıydı (p=0,003). Grup 2 ve grup 3'teki tüm hastaların ortalama Vücut Kitle İndeksi (VKİ) değerleri sırasıyla 16.1 ve 18.6 idi ve grup 2 ile 3 arasındaki fark istatistiksel olarak anlamlıydı (p<0.001). Grup 2'de ASA 1 ve 2 hasta sayısı sırasıyla %87.2 ve %12.1 idi. Grup 3'te ASA 1 ve 2 hasta sayısı sırasıyla %56.4 ve %40.6 idi. ASA skoru açısından grup 2 ve 3 arasındaki fark istatistiksel olarak anlamlıydı (p<0,001).
Sonuç
Anestezik ilaçların riskleri ile ilgili FDA uyarısına göre risk kriterlerine uyan 3 yaş altı hasta bulamadık. Hiçbir hastamızda kardiyak veya pulmoner komplikasyon görülmedi ve beklenmedik bir hastaneye yatış olmadı.
Anahtar Kelimeler: dental tedavi, genel anestezi, çocuk diş hekimliği

Keywords

dental treatment, general anesthesia, pediatric dentistry

ANESTHETIC RISKS IN GENERAL ANESTHESIA PRACTICES IN PEDIATRIC DENTISTRY: A RETROSPECTIVE STUDY

Abstract

Aim: We aimed to evaluate anesthesia-related complications in pediatric patients undergoing dental treatment under general anesthesia (GA).
Materials and Methods: After ethical committee approvel, the records of pediatric patients who were operated between 01.09.2020-01.09.2022 at Selcuk University Faculty of Dentistry General Anesthesia and Sedation Clinic were evaluated with regards of demographic data, ASA, comorbidities, duration of anesthesia, recovery time, cardiac/pulmonary complications, and unanticipated hospitalization rate. The patients were divided into 3 groups according to age as group 1 (0-3 years), group 2 (3-6 years), group 3 (>6 years).
Results: The total number of patients were 398. All patients were between 2-15 years of age. Since the number of patients in group 1 is 7, it was not statistically evaluated in comparisons. The mean duration of anesthesia for all patients was 96.9 minutes, the times in group 2 and group 3 were 100.3 minutes and 88.7 minutes, respectively, and the difference between groups 2 and 3 was statistically significant (p=0.003).The mean BMI values of all patients, in group 2 and in group 3 were 16.1, and 18.6, respectively and the difference between group 2 and 3 was statistically significant (p<0.001). In group 2, the number of ASA 1 and 2 patients were 87.2% and 12.1%, respectively. In group 3, the number of ASA 1 and 2 patients were 56.4% and 40.6%, respectively. The difference between group 2 and 3 regarding ASA score was statistically significant (p<0.001).
Conclusion: We have not found any patients under 3 years of age who were at risk according to the FDA warning regarding the risks of anesthetic drugs. No cardiac or pulmonary complications were observed in any of our patients and there were no unexpected hospitalizations.
Key Words: dental treatment, general anesthesia, pediatric dentistry

Keywords

general anesthesia, pediatric dentistry, dental treatment, pediatric dentistry

References

• 1. Savanheimo N, Sundberg SA, Virtanen JI, Vehkalahti MM. Dental care and treatments provided under general anaesthesia in the Helsinki Public Dental Service. BMC Oral Health. 2012; 12:45.
• 2. AAPD, 2016. Guideline for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures: Update 2016. Pediatr Dent, 38, 6, 216-45.
• 3. Sun L. Early childhood general anaesthesia exposure and neurocognitive development. Br J Anaesth 2010; 105(Suppl 1): i61–i68.
• 4. Ganzberg S. The FDA Warning on Anesthesia Drugs. Anesth Prog 2017 Summer; 64:57-8.
• 5. Reighard, Charles, et al. "Anesthetic Exposure During Childhood and Neurodevelopmental Outcomes: A Systematic Review and Meta-analysis." JAMA network open 5.6 (2022): e2217427-e2217427.
• 6. Bundak, R., Furman, A., Gunoz, H., Darendeliler, F., Bas, F., & Neyzi, O. (2006). Body mass index references for Turkish children. Acta Paediatrica, 95(2), 194-198.
• 7. AAPD. Behaviour Guidance for the pediatric dental patient. 2015.
• 8. Koch, Goran, et al., eds. Pediatric dentistry: a clinical approach. John Wiley & Sons, 2017.
• 9. Chen, Yung-Pan, et al. A 10-year trend of dental treatments under general anesthesia of children in Taipei Veterans General Hospital. Journal of the Chinese Medical Association, 2017, 80.4: 262-268.
• 10. Milsom, K. M., et al. The relationship between anxiety and dental treatment experience in 5-year-old children. British dental journal, 2003, 194.9: 503-506.
• 11. Schrot, Robert J.; Smith, W. F. A review of repeat general anesthesia for pediatric dental surgery in Alberta, Canada. Pediatric Dentistry, 2007, 29.6: 480-487.
• 12. NGU, Katherine P., et al. Prospective evaluation of dental day case general anaesthetic for children. 2001. Master's Thesis. University of Sydney.
• 13. Lee, Pei-Ying, et al. Comprehensive dental treatment under general anesthesia in healthy and disabled children. Chang Gung Med J, 2009, 32.6: 636-42.
• 14. Cantekin, Kenan, et al. Analysis of comprehensive dental rehabilitation under general anesthesia at a dental hospital in Turkey. Journal of Pediatric Dentistry/May-Aug, 2014, 2.2.
• 15. Zhou, Pinping, et al. The effect of sevoflurane anesthesia for dental procedure on neurocognition in children: a prospective, equivalence, controlled trial. BMC pediatrics, 2021, 21.1: 1-10.
• 16. Forsyth, Anna R., et al. General anesthesia time for pediatric dental cases. Pediatric dentistry, 2012, 34.5: 129E-135E.
• 17. TARD (Türkiye Anesteziyoloji ve Reanimasyon Derneği) Günübirlik Anestezi Komitesi Taburculuk Kriterleri.
• 18. Bayrak Ş, Şen Tunç E, Eğilmez T, Tüloğlu N. Ebeveyn dental kaygısı ve sosyodemografik faktörlerin çocukların dental kaygısı üzerine etkileri. J Dent Fac Atatürk Uni. 2010;20:181-88
• 19. Folayan MO, Idehen EE, Ufomata D. The effect of sociodemographic factors on dental anxiety in children seen in a suburban Nigerian hospital. Int J Paediatr Dent. 2003;13: 20-26.
• 20. Nafiu OO, Reynolds PI, Bamgbade OA, et al. Childhood body mass index and perioperative complications. Paediatr Anaesth. 2007;17:426–430
• 21. Nafui OO, Green GE, Walton S, et al. Obesity and risk of peri-operative complications in children presenting for adenotonsillectomy. Int J Pediatr Otorhinolaryngol. 2009;73:89–95.
• 22. Van Caelenberg, Els, et al. Unanticipated admission after ambulatory surgery in the pediatric population: a single-center retrospective analysis. Acta Chirurgica Belgica, 2022, 122.3: 178-184.