[Evaluation of general anesthesia in pediatric dental procedures]

ABSTRACT

The use of general anesthesia for extensive dental procedures in children is sometimes necessary to provide safe, efficient, and effective care. Hospital dentistry and using general anesthesia is limited in our country. The aim of this study was evaluating the extensive pediatric dental procedures which have been done under general anesthesia during a two-year period. This descriptive cross-sectional study was done on 72 pediatric patients who had been transferred into the operating room for dental procedures. General anesthesia was induced with sevoflurane in presence of parents. Then anesthesia was maintained with propofol or remifentanyl and nitrous oxide. Vital signs and any predefined intra and postoperative side effects were recorded. Statistical analysis was performed in SPSS software using mean values and standard deviation. The mean age of the patients was 7.2 +/- 4.10 years and mean anesthesia time was 2.1 +/- 1.48 hours. Thirty one patients [43.1%] had no coexisting disease. 26.4% had cerebral palsy and 15.2% had mental retardation. 15.3% of patients had unknown syndromes. Dental procedures included 215 palpotomies, 57 palpectomies, 293 amalgam fillings, 123 glass-ionomer restorations, 15 scalings, 138 extractions and 101 crown cases. Tachycardia was reported in 9 patients, bradycardia in 7, and hypertension in 6 and hypotension in 1 case during anesthesia. Hemorrhage and swelling were the most common complications during interventions that were seen in 7% and 2.1% respectively. 592 teeth were treated finally. Vomitting, pain and agitation were more common complications after recovery that was reported in 28, 17 and 7 cases respectively. Illusion and restlessness occurred in one patient due to central anticholinorgic syndrome which resolves spontaneously 96 hours after the surgery. Although it is impossible to have a control group under local anesthesia due to long operation time, in our study, extensive dental procedures under general anesthesia were an acceptable method with few preventable complications in special cases such as poor cooperation even in presence of coexisting diseases. Certainly, quality of care will be increased with providing hospital dentistry programs. More studies with more cases are needed