Peripheral oxygen saturation, heart rate, and blood pressure during dental treatment of children with cyanotic congenital heart disease

OBJECTIVES: In this observational study, we evaluated the peripheral oxygen saturation (SpO2), heart rate, and blood pressure of children with cyanotic congenital heart disease who were undergoing dental extraction. METHODS: Forty-four patients between the ages of 6 and 12 years who underwent upper primary tooth extraction were included in the study. Of these, 20 patients were in the cyanotic congenital heart disease group and 24 were in the control group. RESULTS: Peripheral oxygen saturation, heart rate, and systolic blood pressure in the cyanotic congenital heart disease group varied quite significantly during the treatment protocol (p<0.05), with values of 80.5% (±7.6) to 82.8% (±7.8), 95.3 beats per minute (bpm) (±11.3) to 101.3 bpm (±9.8), and 93.6 mm Hg (±13,3) to 103.8 mm Hg (±12.7), respectively. The variations in the control group during the procedure were also significant. CONCLUSIONS: The changes observed during the study protocol, although statistically significant, were mild and lacked clinical relevance. The results indicate that dental treatment of children with cyanotic heart disease using a standardized protocol in decentralized offices without the support of a surgical center is safe. .

Saturação periférica de oxigênio, frequência cardíaca e pressão arterial sistêmica em crianças portadoras de cardiopatia congênita cianogênica com hipofluxo pulmonar durante procedimento odontológico / Oxygen saturation, heart rate and blood pressure in children with cyanotic congenital heart disease with decreased pulmonary blood flow during dental procedures

INTRODUÇÃO: Crianças portadoras de cardiopatia congênita cianogênica com hipofluxo pulmonar (CCCHP) necessitam de tratamento odontológico com frequência. Não encontramos estudos na literatura sobre o impacto na oxigenação dessas crianças durante os procedimentos odontológicos. A hipótese inicial era de que essas crianças submetidas a tratamento odontológico em consultório, poderiam apresentar alterações de saturação periférica de oxigênio (SpO2), pressão arterial sistêmica (PA) e frequência cardíaca (FC). OBJETIVOS: O objetivo principal da pesquisa foi avaliar a ocorrência e magnitude de variações na SpO2, FC e PA em crianças portadoras CCCHP durante exodontia de dente decíduo. Os objetivos secundários foram avaliar o risco potencial de submeter a criança portadora de CCCHP ao tratamento odontológico em consultório e instituir protocolo de atendimento odontológico à criança portadora de cardiopatia congênita do tipo cianogênica. MÉTODOS: Foram estudados 44 pacientes, sendo 20 do grupo de estudo (GE) e 24 do grupo controle (GC), com idade entre 6 e 12 anos submetidos à exodontia de dente decíduo superior. O estudo foi dividido em três períodos: lúdico (PL); anamnese, exame clínico e radiográfico (PAER) e período de procedimento odontológico (PPO), sendo esse último dividido em quatro subperíodos: pré-procedimento (PPR), anestesia (PAN); procedimento (PP) e pós-procedimento (PPP). Durante os períodos foram realizados registros da SpO2, da FC e da PA e aplicada escala de ansiedade facial image scale para avaliação do estresse. RESULTADOS: Os valores da SpO2 , FC e PA sistólica, no GE, durante o protocolo de tratamento variaram, discreta mas significativamente (p<0.05), de 80,5 (±7,6)% a 82,8 (±7,8)%, de 98,7 (±11,0) bpm a 101,3 (±9,8) bpm e de 93,6 a 108,5 mmHg, respectivamente. O GC também apresentou variação significativa durante o procedimento. DISCUSSÃO e CONCLUSÃO: Embora tenham sido observadas alterações significantes nos marcadores estudados durante os...

INTRODUCTION: Children with cyanotic congenital heart disease with decreased pulmonary blood flow (CCHHP) often require dental treatment. We didnt find studies about the impact of the oxygenation in those children during dental procedures. The initial hypothesis was that these children undergoing dental treatment in the clinic could present a peripheral oxygen saturation (SpO2), systolic blood pressure (BP) and heart rate (HR). OBJECTIVES: The main objective of this research was to evaluate the occurrence and magnitude of changes in SpO2, HR and BP in children with CCHHP during extraction of primary deciduous. Secondary objectives were to evaluate the potential risk in subjecting the child with CCHHP to dental treatment in the office and establish protocol for dental care to children with congenital cyanotic type. METHODS: We studied 44 patients, 20 out of the study group (SG) and 24 from control group (CG), aged between 6 and 12 years who underwent upper primary tooth extraction. The study was divided into three periods: leisure time (LT), anamnesis, clinical and radiographic examination period (ACER) and period of dental procedure (PDP), the latter being divided into four sub-periods: pre-procedure (PPR), anesthesia (PAN); procedure (PP) and post-procedure (PPP). During periods of SpO2 records were made of HR and BP and applied an anxiety facial image scale to evaluate the stress. RESULTS: The values of SpO2, HR and systolic BP at SG during the treatment protocol varied, quite but significantly (p <0.05), 80.5 (± 7.6) to 82.8% (± 7, 8)%, 98.7 (± 11.0) to 101.3 bpm (± 9.8) bpm and 93.6 to 108.5 mmHg, respectively. The CG also varied significantly during the procedure. DISCUSSION and CONCLUSION: Although significant changes were observed during the periods studied, they were considered, by the authors, discrete and without clinical relevance, and unnecessary interruption of dental treatment or therapeutic support to children contradicts the initial hypothesis...