Research Article
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Retrospective evaluation of sedation techniques for tooth extraction in pediatric patients

Year 2018, Volume: 21 Issue: 2, 116 - 122, 20.07.2018
https://doi.org/10.7126/cumudj.400765

Abstract

Objective: Due to
lack of past experiences and cooperation in anxious and fearful children,

tooth
extraction may be difficult to manage in dentistry.  The aims of this retrospective study were to evaluate
the various sedation techniques, complications and the characteristics of
children whose tooth extraction were performed with deep sedation.



Materials and Methods: After
approval by the Local Ethics Committee, a retrospective analysis was performed
using the records of 885 patients between the ages of 1-15 years, between 2012
and 2014, and treated with deep sedation for tooth extraction. The authors
described the characteristics of children, the various sedation techniques and
complications.



Results: The mean weight of the
patients was 20.09±7.3 kilogram and the mean age was 5.72±2.5 years.
The
mean duration of the operations was 16.14±5.4 minutes. Propofol, ketamine,
propofol-ketamine combination, alfentanil, midazolam, sevoflurane inhalation,
sevoflurane inhalation+propofol were used fpr the anesthesia. There were no
statistically significant differences among the anesthesic agents, nausea and
vomiting (p=0.09),  and sore throat
(p=0.857) and arrhythmia, bronchospasm and hypoxia (p>0.05).



Conclusions: We
concluded that, propofol was a better option for deep sedation in pediatric
dental extraction due to short duration time, rapid recovery and less
nausea-vomiting. Ketamine-propofol combination may be used as an alternative to
propofol alone.

References

  • 1. Giovannitti JA Jr. Dental anesthesia and pediatric dentistry. Anesth Prog 1995;42:95-9.2. Klingberg G, Vannas Löfqvist L, Bjarnason S, Norén JG. Dental behavior management problems in Swedish children. Community Dent Oral Epidemiol 1994;22:201-5.3. Farhat-McHayleh N, Harfouche A, Souaid P. Techniques for managing behaviour in pediatric dentistry: comparative study of live modelling and tell-show-do based on children's heart rates during treatment. J Can Dent Assoc 2009;75:283.4. Roelofse JA, Joubert JJ, Roelofse PG. A double-blind randomized comparison of midazolam alone and midazolam combined with ketamine for sedation of pediatric dental patients. J Oral Maxillofac Surg 1996;54:838-44. 5. Lourenço-Matharu L, Ashley PF, Furness S. Sedation of children undergoing dental treatment. Cochrane Database Syst Rev 2012;14:3. 6. Major E, Winder M, Brook AH, Berman DS. An evaluation of nitrous oxide in the dental treatment of anxious children. A physiological and clinical study. Br Dent J 1981;15:186-91. 7. Becker DE, Rosenberg M. Nitrous oxide and the inhalation anesthetics. Anesth Prog 2008;55:124-30.8. Seto M, Sakamoto Y, Takahashi H, Kita R, Kikuta T. Does planned intravenous sedation affect preoperative anxiety in patients? Int J Oral Maxillofac Surg 2013;42:497-501.9. Alletag MJ, Auerbach MA, Baum CR. Ketamine, propofol, and ketofol use for pediatric sedation. Pediatr Emerg Care 2012;28:1391-95. 10. Lebovic S, Reich DL, Steinberg LG, Vela FP, Silvay G. Comparison of propofol versus ketamine for anesthesia in pediatric patients undergoing cardiac catheterization. Anesth Analg 1992;74:490-4.11. Hosey MT, Makin A, Jones RM, Gilchrist F, Carruthers M. Propofol intravenous conscious sedation for anxious children in a specialist paediatric dentistry unit. Int J Paediatr Dent 2004;14:2-8. 12. Bredmose PP, Grier G, Davies GE, Lockey DJ. Pre-hospital use of ketamine in paediatric trauma. ActaAnaesthesiol Scand 2009;53:543-5.13. Green SM, Roback MG, Kennedy RM, Krauss B. Clinical practice guideline for emergency department ketamine dissociative sedation: 2011 update. Ann Emerg Med 2011;57:449-61.14. Shah A, Mosdossy G, McLeod S, Lehnhardt K, Peddle M, Rieder M. A blinded, randomized controlled trial to evaluate ketamine/propofol versus ketamine alone for procedural sedation in children. Ann Emerg Med 2011;57:425-33.15. Guit JB, Koning HM, Coster ML, Niemeijer RP, Mackie DP. Ketamine as analgesic for total intravenous anaesthesia with propofol. Anaesthesia 1991;46:24-7. 16. Reves JG, Fragen RJ, Vinik HR, Greenblatt DJ. Midazolam: pharmacology and uses. Anesthesiology. 1985;62:310-24. 17. Wood M. The use of intravenous midazolam and ketamine in paediatric dental sedation. SAAD Dig 2013;29:18-30.18. Burtles R. Alfentanil with methohexitone in paediatric dental anaesthesia. J Dent 1991;19:192-4. 19. Davis PJ, Chopyk JB, Nazif M, Cook DR. Continuous alfentanil infusion in pediatric patients undergoing general anesthesia for complete oral restoration. J ClinAnesth 1991;3:125-30. 20. Kim SO, Kim YJ, Hyun HK, Koo YS, Shin TJ. Deep sedation with sevoflurane inhalation via a nasal hood for brief dental procedures in pediatric patients. Pediatr Emerg Care 2013;29:926-8.21. Higgins PP, Chung F, Mezei G. Postoperative sore throat after ambulatory surgery. Br J Anaesth 2002;88:582-4.
Year 2018, Volume: 21 Issue: 2, 116 - 122, 20.07.2018
https://doi.org/10.7126/cumudj.400765

Abstract

References

  • 1. Giovannitti JA Jr. Dental anesthesia and pediatric dentistry. Anesth Prog 1995;42:95-9.2. Klingberg G, Vannas Löfqvist L, Bjarnason S, Norén JG. Dental behavior management problems in Swedish children. Community Dent Oral Epidemiol 1994;22:201-5.3. Farhat-McHayleh N, Harfouche A, Souaid P. Techniques for managing behaviour in pediatric dentistry: comparative study of live modelling and tell-show-do based on children's heart rates during treatment. J Can Dent Assoc 2009;75:283.4. Roelofse JA, Joubert JJ, Roelofse PG. A double-blind randomized comparison of midazolam alone and midazolam combined with ketamine for sedation of pediatric dental patients. J Oral Maxillofac Surg 1996;54:838-44. 5. Lourenço-Matharu L, Ashley PF, Furness S. Sedation of children undergoing dental treatment. Cochrane Database Syst Rev 2012;14:3. 6. Major E, Winder M, Brook AH, Berman DS. An evaluation of nitrous oxide in the dental treatment of anxious children. A physiological and clinical study. Br Dent J 1981;15:186-91. 7. Becker DE, Rosenberg M. Nitrous oxide and the inhalation anesthetics. Anesth Prog 2008;55:124-30.8. Seto M, Sakamoto Y, Takahashi H, Kita R, Kikuta T. Does planned intravenous sedation affect preoperative anxiety in patients? Int J Oral Maxillofac Surg 2013;42:497-501.9. Alletag MJ, Auerbach MA, Baum CR. Ketamine, propofol, and ketofol use for pediatric sedation. Pediatr Emerg Care 2012;28:1391-95. 10. Lebovic S, Reich DL, Steinberg LG, Vela FP, Silvay G. Comparison of propofol versus ketamine for anesthesia in pediatric patients undergoing cardiac catheterization. Anesth Analg 1992;74:490-4.11. Hosey MT, Makin A, Jones RM, Gilchrist F, Carruthers M. Propofol intravenous conscious sedation for anxious children in a specialist paediatric dentistry unit. Int J Paediatr Dent 2004;14:2-8. 12. Bredmose PP, Grier G, Davies GE, Lockey DJ. Pre-hospital use of ketamine in paediatric trauma. ActaAnaesthesiol Scand 2009;53:543-5.13. Green SM, Roback MG, Kennedy RM, Krauss B. Clinical practice guideline for emergency department ketamine dissociative sedation: 2011 update. Ann Emerg Med 2011;57:449-61.14. Shah A, Mosdossy G, McLeod S, Lehnhardt K, Peddle M, Rieder M. A blinded, randomized controlled trial to evaluate ketamine/propofol versus ketamine alone for procedural sedation in children. Ann Emerg Med 2011;57:425-33.15. Guit JB, Koning HM, Coster ML, Niemeijer RP, Mackie DP. Ketamine as analgesic for total intravenous anaesthesia with propofol. Anaesthesia 1991;46:24-7. 16. Reves JG, Fragen RJ, Vinik HR, Greenblatt DJ. Midazolam: pharmacology and uses. Anesthesiology. 1985;62:310-24. 17. Wood M. The use of intravenous midazolam and ketamine in paediatric dental sedation. SAAD Dig 2013;29:18-30.18. Burtles R. Alfentanil with methohexitone in paediatric dental anaesthesia. J Dent 1991;19:192-4. 19. Davis PJ, Chopyk JB, Nazif M, Cook DR. Continuous alfentanil infusion in pediatric patients undergoing general anesthesia for complete oral restoration. J ClinAnesth 1991;3:125-30. 20. Kim SO, Kim YJ, Hyun HK, Koo YS, Shin TJ. Deep sedation with sevoflurane inhalation via a nasal hood for brief dental procedures in pediatric patients. Pediatr Emerg Care 2013;29:926-8.21. Higgins PP, Chung F, Mezei G. Postoperative sore throat after ambulatory surgery. Br J Anaesth 2002;88:582-4.
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Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Research Articles
Authors

Dilek Günay Canpolat

Nükhet Kütük

Canay Yılmaz Asan

Alper Alkan

Publication Date July 20, 2018
Submission Date March 2, 2018
Published in Issue Year 2018Volume: 21 Issue: 2

Cite

EndNote Günay Canpolat D, Kütük N, Yılmaz Asan C, Alkan A (July 1, 2018) Retrospective evaluation of sedation techniques for tooth extraction in pediatric patients. Cumhuriyet Dental Journal 21 2 116–122.

Cumhuriyet Dental Journal (Cumhuriyet Dent J, CDJ) is the official publication of Cumhuriyet University Faculty of Dentistry. CDJ is an international journal dedicated to the latest advancement of dentistry. The aim of this journal is to provide a platform for scientists and academicians all over the world to promote, share, and discuss various new issues and developments in different areas of dentistry. First issue of the Journal of Cumhuriyet University Faculty of Dentistry was published in 1998. In 2010, journal's name was changed as Cumhuriyet Dental Journal. Journal’s publication language is English.


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