Öz
Purpose:General anesthesia applications in dentistry are
becoming increasingly widespread. Risks related to anesthesia should be
seriously questioned in the patient group under dental treatment planning under
general anesthesia. We aimed to evaluate the
clinical and demographic data of patients who were operated with general
anesthesia and sedation during our study in our hospital, and discussed in the
light of the literature
Materials and Methods:A retrospective study of 3380 cases treated
between April 2014 and April 2016 was reviewed. Demographic data obtained from
patient files, ASA Scores, length of hospital stay,type of anesthesia,
duration of anesthesia,complications occurring, anesthetic agents and
analgesics used, patients with syndrome and the desired consultations
were evaluated.
Results:Of the 3380 cases, 55%
were female, 45% were male and the mean age was 11.23 ± 12.09. The distribution
according to ASA scores was 84.4% ASA I, 15.2% ASA II, 0.4% ASA III. In 3085
patients the procedure was performed by outpatient surgery procedure, while 276
patients were treated inpatient. The consultations requested from the patients
were mostly from the pediatric and neurology clinics. The most common
postoperative complication was bradycardia, and the least complication was
difficult intubation. The most common causes of comorbidities were mental
retardation, congenital heart disease, and epilepsy.
Conclusion:The method of anesthesia is also important
especially in the pediatric age group due to the frequency of genetic
syndromes, mental retardation, concomitant cardiac and respiratory problems.
Precautions should be taken to avoid mortality and morbidity due to anesthesia.
Vital risks should be avoided.
Anahtar Kelimeler
Kaynakça
- 1. Alkış N. Anestezi Tarihi. Ankara Üniversitesi Dikimevi Sağlık Hizmetleri Meslek Yüksekokulu Yıllığı. 2000; Cilt 1,Sayı1.2. Özkan AS, Erdoğan MA, Şanlı M, Kaçmaz O, Durmuş M, Çolak C. Retrospective Evaluation of Dental Treatment under General Anaesthesia. Turk J Anaesth Reanim. 2015; 43: 332-63. Savanheimo N, Sundberg SA, Virtanen JI, Vehkalahti MM.Dental care and treatments provided under general anaesthesia in the Helsinki Public Dental Service. BMC Oral Health. 2012;12:45.4. Karacalar S, Aykaç B. Dental girişimlerde genel anestezi uygulamaları. Marmara Medical Journal. 2010;23(3);400-407.5. Park C, Kim S. Survey of the sevoflurane sedation status in one provincial dental clinic center for the disabled. J Dent Anesth Pain Med. 2016;16(4):283–288.6. Wood M. The use of intravenous midazolam and ketamine in paediatric dental sedation. SAAD Dig. 2013;29:18-30.7. Kaviani N, Ashrafi S, Jabbarifar SE, Ghaffari E. The Efficacy of Two Intravenous Sedative Drugs inManagement of Uncooperative Children for Dental Treatments. J Dent Shiraz UnivMed Sci., 2015;16(1 Suppl):29-34.8. Rodrigo C, GIrwin M, Bill BS, HeiWong M. Patient-controlled sedation with propofol in minor oral surgery. Journal of Oral and Maxillofacial Surgery. 2004;62(1):52-569. Corcuera-Flores JR , Delgado-Muñoz JM, Ruiz-Villandiego JC, MauraSolivellas İ, Machuca-Portillo G. Dental treatment for handicapped patients; sedation vs general anesthesia and update of dental treatment in patients with different diseases.Med Oral Patol Oral Cir Bucal. 2014;19 (2):e170-6 10. Nelson TM, Xu Z. Pediatric dental sedation: challenges and opportunities. Clinical, Cosmetic and Investigational Dentistry. 2015;7: 97–10611. ME Sari, B Ozmen, AE Koyuturk, U Tokay. A retrospective comparison of dental treatment under general anesthesia on children with and without mental disabilities. Nigerian Journal of Clinical Practice . 2014:17(3):361-6512. Wilson KE. Overview of paediatric dental sedation: Nitrous oxide/oxygen inhalation sedation.Dent Update. 2013;40(10):822-4, 826-9.13. Galeotti A, Bernardin AG, D’Antò V, Ferrazzano GF , Gentile T, Viarani V, Cassabgi G and Cantile T. İnhalation Conscious Sedation with Nitrous Oxide and Oxygen as Alternative to General Anesthesia in Precooperative, Fearful, and Disabled Pediatric Dental Patients: A Large Survey on 688 Working Sessions. BioMed Research International. 2016:1-6 14. Shavlokhova EA, Ostreĭkov IF, Korolenkova MV. Sedation with midazolam for ambulatory pediatric dentistry. Anesteziol Reanimatol. 2014;59(5):48-52.15. Hung WT1, Hsu SC, Kao CT. General anesthesia for developmentally disabled dental care patients: a comparison of reinforced laryngeal mask airway and endotracheal intubation anesthesia. Spec Care Dentist. 2003;23(4):135-8.16. L Holzapfel. Nasal vs Oral intubation. Minerva Anestesiol. 2003;69:348-5217. Zaytcev AY, Dubrovin KV, Svetlov VA . The choıce of tracheal ıntubatıon method ın reconstructıve maxıllo-facıal surgery wıth dıffıcult aırways. Anesteziol Reanimatol. 2017 ;61:173-177.18. Martin J, Tau G, Cherian MN, Vergel de Dios J, Mills D, Fitzpatrick J, Adu-Krow W, Cheng D. Survey of the capacity for essential surgery and anaesthesia services in Papua New Guinea. BMJ Open. 2015;5:e00984119. Esteve N1, Valdivia J, Ferrer A, Mora C, Ribera H, Garrido P. Rev Esp Anestesiol Reanim. Do anesthetic techniques influence postoperative outcomes? 2013;60(2):93-102. 20. Jung YS1, Kim DK, Kim MK, Kim HJ, Cha IH, Lee EW. Onset of analgesia and analgesic efficacy of tramadol/acetaminophen and codeine/acetaminophen/ibuprofen in acute postoperative pain: a single-center, single-dose, randomized, active-controlled, parallel-group study in a dental surgery pain model. Clin Ther. 2004;26(7):1037-45.21. Wong M, Copp PE, Haas AD. - Postoperative Pain in Children After Dentistry Under General Anesthesia. Anesth Prog. 2015; 62:140–152 22. Faria PF, Nicolau JA, Melek MZ, de Oliveira Nde S, Bermudez BE, Nisihara RM. Association between congenital heart defects and severe infections in children with Down syndrome. Rev Port Cardiol. 2014;33(1):15-8.23. Plicht B, Lind A, Erbel R . Infective endocarditis : New ESC guidelines 2015. İnternist (Berl). 2016;57(7):675-90.
Öz
Amaç:Diş hekimliğinde genel anestezi uygulamaları
giderek yaygınlaşmaktadır. Genel anestezi altında dental tedavi planlanan hasta
grubunda anesteziye ait riskler ciddi anlamda sorgulanmalıdır. Çalışmamızda hastanemiz
ameliyathanesinde genel anestezi ve sedasyon ile opere edilen olguların klinik
ve demografik verileri
değerlendirilerek literatür
eşliğinde tartışılması amaçlanmıştır
Gereç ve Yöntem:2014 nisan-2016 nisan tarihleri arasında tedavi
olmuş 3380 vakanın dosyası retrospektif olarak incelendi. Hasta dosyalarından
elde edilen demografik veriler, ASA Skorları, hastaların yatış süreleri,
anestezinin türü, anestezi süresi, oluşan komplikasyonlar, kullanılan anestezik
ajanlar ve analgezikler, sendromlu hastalar ve
istenilen konsültasyonlar değerlendirildi
Bulgular:3380
vakanın %55’i kadın, %45’i erkek olup yaş ortalaması 11,23±12,09 idi. ASA
skorlarına göre dağılımı %84.4 ASA I, %15.2 ASA II, %0.4 ASA III şeklindeydi. 3085
hastada işlem günübirlik cerrahi prosedürü ile gerçekleştirilirken, 276 hastada
yatarak tedavi edildi. Hastalardan istenen konsültasyonlar en fazla pediatri ve
nöroloji kliniklerine aitti. En sık görülen postoperatif komplikasyon
bradikardi olurken, en az komplikasyon
ise zor entübasyon oldu. En sık komorbidite sebepleri: mental retardasyon,
konjenital kalp hastalığı ve epilepsi idi.
Sonuç:Özellikle pediatrik yaş grubunda genetik sendromların sıklığı, mental
retardasyon, eşlik eden kardiyak ve
solunumsal problemleri nedeniyle
anestezi yöntemi ayrıca önemlidir. Anesteziye bağlı
oluşabilecek mortalite ve morbiditenin önüne geçmek için önlemler alınmalıdır. Hayati riskler ekarte edilmeye çalışılmalıdır.
Anahtar Kelimeler
Kaynakça
- 1. Alkış N. Anestezi Tarihi. Ankara Üniversitesi Dikimevi Sağlık Hizmetleri Meslek Yüksekokulu Yıllığı. 2000; Cilt 1,Sayı1.2. Özkan AS, Erdoğan MA, Şanlı M, Kaçmaz O, Durmuş M, Çolak C. Retrospective Evaluation of Dental Treatment under General Anaesthesia. Turk J Anaesth Reanim. 2015; 43: 332-63. Savanheimo N, Sundberg SA, Virtanen JI, Vehkalahti MM.Dental care and treatments provided under general anaesthesia in the Helsinki Public Dental Service. BMC Oral Health. 2012;12:45.4. Karacalar S, Aykaç B. Dental girişimlerde genel anestezi uygulamaları. Marmara Medical Journal. 2010;23(3);400-407.5. Park C, Kim S. Survey of the sevoflurane sedation status in one provincial dental clinic center for the disabled. J Dent Anesth Pain Med. 2016;16(4):283–288.6. Wood M. The use of intravenous midazolam and ketamine in paediatric dental sedation. SAAD Dig. 2013;29:18-30.7. Kaviani N, Ashrafi S, Jabbarifar SE, Ghaffari E. The Efficacy of Two Intravenous Sedative Drugs inManagement of Uncooperative Children for Dental Treatments. J Dent Shiraz UnivMed Sci., 2015;16(1 Suppl):29-34.8. Rodrigo C, GIrwin M, Bill BS, HeiWong M. Patient-controlled sedation with propofol in minor oral surgery. Journal of Oral and Maxillofacial Surgery. 2004;62(1):52-569. Corcuera-Flores JR , Delgado-Muñoz JM, Ruiz-Villandiego JC, MauraSolivellas İ, Machuca-Portillo G. Dental treatment for handicapped patients; sedation vs general anesthesia and update of dental treatment in patients with different diseases.Med Oral Patol Oral Cir Bucal. 2014;19 (2):e170-6 10. Nelson TM, Xu Z. Pediatric dental sedation: challenges and opportunities. Clinical, Cosmetic and Investigational Dentistry. 2015;7: 97–10611. ME Sari, B Ozmen, AE Koyuturk, U Tokay. A retrospective comparison of dental treatment under general anesthesia on children with and without mental disabilities. Nigerian Journal of Clinical Practice . 2014:17(3):361-6512. Wilson KE. Overview of paediatric dental sedation: Nitrous oxide/oxygen inhalation sedation.Dent Update. 2013;40(10):822-4, 826-9.13. Galeotti A, Bernardin AG, D’Antò V, Ferrazzano GF , Gentile T, Viarani V, Cassabgi G and Cantile T. İnhalation Conscious Sedation with Nitrous Oxide and Oxygen as Alternative to General Anesthesia in Precooperative, Fearful, and Disabled Pediatric Dental Patients: A Large Survey on 688 Working Sessions. BioMed Research International. 2016:1-6 14. Shavlokhova EA, Ostreĭkov IF, Korolenkova MV. Sedation with midazolam for ambulatory pediatric dentistry. Anesteziol Reanimatol. 2014;59(5):48-52.15. Hung WT1, Hsu SC, Kao CT. General anesthesia for developmentally disabled dental care patients: a comparison of reinforced laryngeal mask airway and endotracheal intubation anesthesia. Spec Care Dentist. 2003;23(4):135-8.16. L Holzapfel. Nasal vs Oral intubation. Minerva Anestesiol. 2003;69:348-5217. Zaytcev AY, Dubrovin KV, Svetlov VA . The choıce of tracheal ıntubatıon method ın reconstructıve maxıllo-facıal surgery wıth dıffıcult aırways. Anesteziol Reanimatol. 2017 ;61:173-177.18. Martin J, Tau G, Cherian MN, Vergel de Dios J, Mills D, Fitzpatrick J, Adu-Krow W, Cheng D. Survey of the capacity for essential surgery and anaesthesia services in Papua New Guinea. BMJ Open. 2015;5:e00984119. Esteve N1, Valdivia J, Ferrer A, Mora C, Ribera H, Garrido P. Rev Esp Anestesiol Reanim. Do anesthetic techniques influence postoperative outcomes? 2013;60(2):93-102. 20. Jung YS1, Kim DK, Kim MK, Kim HJ, Cha IH, Lee EW. Onset of analgesia and analgesic efficacy of tramadol/acetaminophen and codeine/acetaminophen/ibuprofen in acute postoperative pain: a single-center, single-dose, randomized, active-controlled, parallel-group study in a dental surgery pain model. Clin Ther. 2004;26(7):1037-45.21. Wong M, Copp PE, Haas AD. - Postoperative Pain in Children After Dentistry Under General Anesthesia. Anesth Prog. 2015; 62:140–152 22. Faria PF, Nicolau JA, Melek MZ, de Oliveira Nde S, Bermudez BE, Nisihara RM. Association between congenital heart defects and severe infections in children with Down syndrome. Rev Port Cardiol. 2014;33(1):15-8.23. Plicht B, Lind A, Erbel R . Infective endocarditis : New ESC guidelines 2015. İnternist (Berl). 2016;57(7):675-90.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Haziran 2019 |
| Kabul Tarihi | 22 Eylül 2018 |
| Yayımlandığı Sayı | Yıl 2019 Cilt: 44 Sayı: 2 |
Cited By
Pediatric Dentistry and General Anesthesia
Ankara Medical Journal
Cansu Özşin Özler
https://doi.org/10.17098/amj.624720
