RESUMO
Background and Objective: Airway safety may be provided with endotracheal intubation especially for oral procedures because of some potential risks such as aspiration of secretion or foreign bodies. In this study, we aimed to determine whether placing a pillow under the occiput may facilitate endotracheal intubation in non-cooperative children whose extensive dental treatments were planned to take place under general anesthesia
Methods: The study was performed in Erciyes University, Faculty of Dentistry between March-July 2014. A total 150 ASA I-II children, between 3-9 years were included in this study. Pillow was folded under the occiput in Group 1 [n=75], patients lay on a flat surface in Group 2 [n=75] during the anesthesia induction and intubation period
Results: There were no statistically significant differences between groups regarding the demographic data [age, weight, gender] [p>0.05]. Operation times were similar in both groups [p=0.329]. The number of intubation attempts was smilar in both groups [p=0.412]. The intubation time was longer in group one than in group two [p= 0.025]
Conclusion: We concluded that, placing a pillow under the patients occiput provided longer intubation time without changing the number of attempts in the normal airway in non-cooperative children whose extensive dental treatments were planned to take place under general anesthesia
RESUMO
Background and Objective: Dental treatments cannot be always performed under local anesthesia in pediatric non-cooperative patients. For this purpose, different anesthetic techniques have been applied to increase patient comport to dental treatments
Methods: Sixty children classified as ASA I-II, between aged 3 to 9, who were scheduled to undergo tooth extraction, were enrolled for this randomized study. Group K received 1 mg/kg ketamine, Group P received 1 mg/kg propofol, and Group KP received 0.5 mg/kg propofol plus 0.5 mg/kg ketamine intravenously for anesthesia induction
Results: Recovery time was significantly lower in Group P than Group KP. No significant differences were found between groups regarding HR, before and after the induction, at tenth minute. Fifth minute's HR was higher in Group K than Group KP. Mean arterial pressure [MAP] values were similar at baseline, before and after the induction, and at tenth minute, whereas significantly lower values were found in Group P and Group KP than in Group K at fifth minute
Conclusions: Although ketamine, propofol and ketamine-propofol combination are effective for sedation in tooth extraction in pediatric patients, propofol may be an excellent alternative, with the shortest recovery, no nausea and vomiting, and reasonable surgical satisfaction
RESUMO
To find out postoperative discomfort in children undergoing dental rehabilitation under general anesthesia [DRGA]. This study involved 78 [4 to 10 year-old] healthy patients who were scheduled for DRGA and were needed extensive dental treatment because of severe caries, and showed high dental fear and/or behavioral management problems. The children had to be fit for DRGA administration by fulfilling the American Society of Anesthesiologists physical status I or II and no associated mental health or communication problems. Data were collected by structured interview either face to face [immediately post operation] or using a telephone [post operation after discharge]. One of the study's investigators recorded all data related to the immediate postoperative period during the child's stay in the post-anesthesia care unit [PACU]. The questionnaire consisted of questions related to postoperative problems experienced by the patient in the period after their day-stay attendance. The questionnaire, consisting of questions regarding and generally related to the child's activities. In addition, pain was assessed using the face, legs, activity, cry, consolability [FLACC] scale. The prevalence of postoperative problems was 46 out of 78 [59%]. The mean FLACC score was 1.8 [SD=2.1]. Some of the patients having more than one reported problem. Forty-one percent of the children showed nasal discomfort [P < 0.01]. Thirty-three percent and 43% of the children experienced throat or mouth discomfort. The most common experienced postoperative symptom after DRGA was bleeding. Nasal bleeding, however, was an uncommon complication and did not cause serious morbidity or mortality in children intubated nasotracheally. In addition, postoperative discomfort was related to number of the extractions. Children who had 4 or more extractions were more likely to experience pain. Findings associated with other bodily functions were assessed. Nausea and vomiting were reported in 20.5% of children. Twenty-six children [18%] had a fever. Thirty-nine [50.0%] parents reported that their children had problems eating. Post-operative discomfort was more with 4 or more extraction done under DRGA and that nasal bleeding was noted a uncommon post-operative symptom