Holt R D, Rule D C, Davenport E S, Fung D E
Department of Children's Dentistry, Institute of Dental Surgery, London.
Br Dent J. 1992;173(10):333-9. doi: 10.1038/sj.bdj.4808048.
Following publication of the Poswillo report, the continued use of general anaesthesia in dentistry became the subject of a major debate. In particular, the provision of general anaesthetic services by general dental practitioners in order to carry out simple extractions for child patients has been called into question. Other authors have strongly supported the continued need for general anaesthesia and insist that for some patients it remains the technique of choice. There is, however, little evidence of current patterns of attendance from which argument may be advanced to support or refute the differing views. In this study data was drawn from three London dental teaching hospitals providing out-patient general anaesthesia for extractions. During the 12-month period investigated 7852 general anaesthetics had been administered for child patients. There was evidence of an increase in numbers at one centre when results were compared to those of a previous study and some evidence of a change in pattern of referral with time at the same centre, with an increase in the numbers of patients referred by general dental practitioners. Eighty-three per cent of the anaesthetics had been given for the extraction of carious primary teeth, with an average of 3.3 being extracted per child. Nearly one-third of the anaesthetics were for children under the age of 5 years.
在波斯维洛报告发表之后,牙科领域全身麻醉的持续使用成为了一场重大辩论的主题。特别是,普通牙科从业者提供全身麻醉服务以给儿童患者进行简单拔牙手术的做法受到了质疑。其他作者则强烈支持持续需要全身麻醉,并坚称对于一些患者来说,它仍然是首选技术。然而,几乎没有当前就诊模式的证据可用于支持或反驳这些不同观点。在这项研究中,数据取自三家为拔牙提供门诊全身麻醉的伦敦牙科教学医院。在调查的12个月期间,已为儿童患者实施了7852例全身麻醉。与之前一项研究的结果相比,有证据表明一个中心的麻醉例数有所增加,并且在同一中心有一些证据显示随着时间推移转诊模式发生了变化,普通牙科从业者转诊的患者数量有所增加。83%的麻醉是用于拔除龋坏的乳牙,每个儿童平均拔除3.3颗。近三分之一的麻醉是为5岁以下儿童进行的。