Çocuk Hastalarda İntraoperatif Analjezinin Genel Anestezi Altında Yapılmış Olan Diş Tedavilerinden Sonraki Ağrı Algısı Üzerine Etkisinin Değerlendirilmesi

Year 2023, Volume: 10 Issue: 3, 516 - 521, 25.12.2023

Elif Öntekin Gül Tosun , Funda Arun

https://doi.org/10.15311/selcukdentj.1236167

Abstract

ÖZ
Amaç: Genel anestezi (GA) altında diş tedavisi sırasında intraoperatif verilen parasetamolün postoperatif ağrı algısı üzerine etkisini değerlendirmeyi amaçladık.
Gereç ve Yöntem: Etik kurul onayı alındıktan sonra Selçuk Üniversitesi Diş Hekimliği Fakültesi Genel Anestezi ve Sedasyon Kliniği’nde 2020-2021 yıllarında günübirlik anestezi ile tedavileri yapılmış olan çocuk hastaların kayıtları kullanılmıştır. Hastaların anestezi dosyalarından demografik verileri, anestezi süreleri, dental tedavi süreleri, yapılan ağrılı işlemler, lokal anestezik kullanımı, intraoperatif parasetamol kullanımı, postoperatif 1. ve 2. saat kaydedilmiş ağrı skorları, servise çıkış süreleri, derlenme odasında ek ağrı kesici yapılıp yapılmadığı ile ilgili veriler taranmıştır. Çalışmanın istatistiksel analizleri için “Microsoft Excel 2016” ve “IBM SPSS Statistics 26” paket programları kullanılmıştır. Temel demografik tanımlayıcı istatistikler için sıklık ve oransal dağılım verilmiş ve birbirleriyle çaprazlamaları incelenmiştir.
Bulgular: Çalışmaya dahil edilen 246 çocuk hastanın 136’sı erkek ve 110’u kız; en küçüğü 3 ve en büyüğü 15 yaşında idi. Bu hastaların anestezi kayıtlarının istatiksel değerlendirilmesiyle elde ettiğimiz sonuçlara göre; intraoperatif parasetamol uygulanmış grupla uygulanmamış grup arasında; postoperatif 1. saat ağrı skorlarında, taburculuk sürelerinde, postoperatif dönemde ek analjezik ihtiyaçlarında istatistiksel olarak anlamlı bir fark gözlemlenirken, postoperatif 2. saat ağrı skorlarında, vücut ağırlıklarında ve cinsiyet dağılımında anlamlı bir fark bulunmamıştır.
Sonuç: İntraoperatif olarak uygulanan parasetamolün çocuk hastalara daha konforlu bir postoperatif süreç yaşattığını düşünmekteyiz.
Anahtar Kelimeler: dental tedavi, genel anestezi, parasetamol

Keywords

dental tedavi, çocuk diş hekimliği, genel anestezi

Supporting Institution

SELÇUK ÜNİVERSİTESİ BAP

Project Number

22132004

Evaluatıon of the Effect of Intraoperatıve Analgesıa on Paın Perceptıon After Dental Treatments Under General Anesthesıa in Pediatric Patients

Abstract

Abstract
Aim: In this study, we aimed to evaluate the effect of intraoperatively administered paracetamol during dental treatment under general anesthesia (GA) on postoperative pain perception.

Materials and Methods: After obtaining ethical approval, records of pediatric patients who underwent day-case anesthesia for dental treatments at the General Anesthesia and Sedation Clinic of Selçuk University Faculty of Dentistry in the years 2020-2021 were used. Demographic data, anesthesia durations, dental treatment durations, performed painful procedures, use of local anesthetics, intraoperative use of paracetamol, recorded pain scores at postoperative 1st and 2nd hours, discharge times, and whether additional analgesics were administered in the recovery room were scanned from the patients' anesthesia files. "Microsoft Excel 2016" and "IBM SPSS Statistics 26" package programs were used for the statistical analysis. Frequency and proportional distribution were given for basic demographic descriptive statistics, and their cross-tabulations were examined.

Results: Of the 246 pediatric patients included in the study, 136 were male and 110 were female, ranging from 3 to 15 years old. According to the results obtained from the statistical evaluation of the anesthesia records of these patients, a statistically significant difference was observed between the group where intraoperative paracetamol was administered and the group where it was not administered in postoperative 1st-hour pain scores, discharge times, and additional analgesic requirements in the postoperative period. However, no significant difference was found in postoperative 2nd-hour pain scores, body weights, and gender distribution.

Conclusion: We believe that intraoperatively administered paracetamol provides a more comfortable postoperative process for pediatric patients.

Keywords: dental treatment, general anesthesia, paracetamol

Keywords

dental treatment, general anesthesia, paracetamol

Project Number

22132004

References

• 1. Aypar, Ü. And S.B. Akıncı, Diş Hekimliği Ve Anestezi. Nobel Tıp Kitabevleri, 2005:135-146.
• 2. Özler, C.Ö., T.İ. Keçeli, And M.U. Tekçiçek, Çocuk Diş Hekimliği Ve Genel Anestezi. Ankara Medical Journal, 2019;19(3):658-664.
• 3. Anesteziyoloji, T. And R. Derneği, Anestezi Uygulama Kılavuzları. Postoperatif Ağrı Tedavisi, 2006: 2-18.
• 4. Urman, R.D. And S.P. Desai, History Of Anesthesia For Ambulatory Surgery. Current Opinion İn Anesthesiology, 2012;25(6):641-647.
• 5. White, P.F., Ambulatory Anesthesia Advances İnto The New Millennium. Anesthesia & Analgesia, 2000;90(5): 1234-1235.
• 6. Cravero, J.P. And G.T. Blike, Review Of Pediatric Sedation. Anesthesia & Analgesia, 2004;99(5):1355-1364.
• 7. Olatunji, O.O., Preventıon Of Paın On Propofol Injectıon: A Comparıson Of Lıgnocaıne Wıth A Combınatıon Of Metoclopramıde/Lıgnocaıne. Faculty Of Anaesthesia, 2010.
• 8. Wong, M., P.E. Copp, And D.A. Haas, Postoperative Pain İn Children After Dentistry Under General Anesthesia. Anesthesia Progress, 2015;62(4):140-152.
• 9. Chou, R., Et Al., Management Of Postoperative Pain: A Clinical Practice Guideline From The American Pain Society, The American Society Of Regional Anesthesia And Pain Medicine, And The American Society Of Anesthesiologists' Committee On Regional Anesthesia, Executive Committee, And Administrative Council. The Journal Of Pain, 2016; 17(2):131-157.
• 10. Crile, G., The Kinetic Theory Of Shock And İts Prevention Through Anoci-Association (Shockless Operation). The Lancet, 1913;182(4688):7-16.
• 11. Yentür, E., Preemtif, Preventif Analjezi. Postopetatif Ağrı Tedavisi. İstanbul: İstanbul Tıp Kitabevleri, 2019: 31-6.
• 12. Frizzell, K.H., P.K. Cavanaugh, And M.J. Herman, Pediatric Perioperative Pain Management. Orthopedic Clinics, 2017;48(4):467-480.
• 13. Baygin, O., Et Al., Comparison Of Pre‐Emptive İbuprofen, Paracetamol, And Placebo Administration İn Reducing Post‐Operative Pain İn Primary Tooth Extraction. International Journal Of Paediatric Dentistry, 2011;21(4):306-313.
• 14. Vahedi, H.S.M., Et Al., Comparison Between İntravenous Morphine Versus Fentanyl İn Acute Pain Relief İn Drug Abusers With Acute Limb Traumatic İnjury. World Journal Of Emergency Medicine, 2019; 10(1): P. 27.
• 15. Pope, N., Et Al., Experiences Of Acute Pain İn Children Who Present To A Healthcare Facility For Treatment: A Systematic Review Of Qualitative Evidence. Jbı Evidence Synthesis, 2017.;15(6): 1612-1644.
• 16. Kissin, I. And R.B. Weiskopf, Preemptive Analgesia. The Journal Of The American Society Of Anesthesiologists, 2000;93(4):1138-1143.
• 17. Dahl, T., Textual Metadiscourse İn Research Articles: A Marker Of National Culture Or Of Academic Discipline? Journal Of Pragmatics, 2004;36(10): 1807-1825.
• 18. El Batawi, H., Effect Of İntraoperative Analgesia On Children’s Pain Perception During Recovery After Painful Dental Procedures Performed Under General Anaesthesia. European Archives Of Paediatric Dentistry, 2015;16(1): 35-41.
• 19. Wong, Michelle; Copp, Peter E.; Haas, Daniel A. Postoperative Pain İn Children After Dentistry Under General Anesthesia. Anesthesia Progress, 2015;62.4: 140-152.
• 20. Farsi, N., Et Al., Postoperative Complications Of Pediatric Dental General Anesthesia Procedure Provided İn Jeddah Hospitals, Saudi Arabia. Bmc Oral Health, 2009; 9(1): 1-9.
• 21. Chou, R., Et Al., Guidelines On The Management Of Postoperative Pain. J Pain, 2016; 17(2): 131-157.
• 22. Özyalçın, S. And S. Dinçer, Çocuklarda Ağrı. Klinik Gelişim, 2007; 69(140): 136-140.
• 23. Moore, P., G. Acs, And J. Hargreaves, Postextraction Pain Relief İn Children: A Clinical Trial Of Liquid Analgesics. International Journal Of Clinical Pharmacology, Therapy, And Toxicology, 1985; 23(11): 573-577.
• 24. Gazal, G. And I.C. Mackie, A Comparison Of Paracetamol, İbuprofen Or Their Combination For Pain Relief Following Extractions İn Children Under General Anaesthesia: A Randomized Controlled Trial. International Journal Of Paediatric Dentistry, 2007.;17(3): 169-177.
• 25. Mcgaw, T., W. Raborn, And M. Grace, Analgesics İn Pediatric Dental Surgery: Relative Efficacy Of Aluminum İbuprofen Suspension And Acetaminophen Elixir. Asdc Journal Of Dentistry For Children, 1987;54(2): 106-109.
• 26. Katz, J. And C.J. Mccartney, Current Status Of Pre-Emptive Analgesia. Current Opinion İn Anesthesiology, 2002;15(4): 435-441.
• 27. Pozos-Guillen, A., Et Al., Pre-Emptive Analgesic Effect Of Tramadol After Mandibular Third Molar Extraction: A Pilot Study. Journal Of Oral And Maxillofacial Surgery, 2007;65(7):1315-1320.
• 28. Primosch, R., S. Antony, And F. Courts, The Efficacy Of Preoperative Analgesic Administration For Postoperative Pain Management Of Pediatric Dental Patients. Anesthesia & Pain Control İn Dentistry, 1993;2(2): 102-106.
• 29. Zhang, Q., Et Al., Postoperative Complications İn Chinese Children Following Dental General Anesthesia: A Cross-Sectional Study. Medicine, 2020:99(45).
• 30. Atan, S., Et Al., Morbidity Following Dental Treatment Of Children Under İntubation General Anaesthesia İn A Day‐Stay Unit. International Journal Of Paediatric Dentistry, 2004;14(1): 9-16.