Messieha Zakaria, Ananda Ranga Chelva, Hoffman Ian, Hoffman William
Department of Anesthesiology, University of Illinois at Chicago Medical Center, Chicago, IL 60612, USA.
Anesth Prog. 2007 Winter;54(4):170-4. doi: 10.2344/0003-3006(2007)54[170:FYOSOD]2.0.CO;2.
We assessed the safety of general anesthesia for dental treatment of special needs patients as it related to American Society of Anesthesiology Physical Status (ASAPS) classification, procedure, and other factors. After Institutional Review Board review and approval, special needs patients who were admitted to the outpatient surgical operating room for comprehensive dental rehabilitation (CDR) under general anesthesia within a period of 5 years had their medical records evaluated retrospectively for intraoperative and postoperative complications both related to anesthesia and surgery. All records were evaluated by an independent evaluator who tabulated the patients' age, gender, ASAPS, and duration of procedure. N = 363, age mean = 46.93 +/- 16.835 years, age median = 48 years, male patients = 180, female patients = 183, ASAPS I =183, ASAPS II = 127, ASAPS III = 53, duration of surgery mean = 140.631 +/- 23.104 minutes, duration of surgery median time = 142.000 minutes, and number of complications = 2. One complication resulted in an ASAPS I 16-year-old boy, which was airway related, and a second was an ASAPS III 22-year-old woman, which was surgically related. Both led to unplanned inpatient admissions and were treated successfully with no residual morbidity. Dental rehabilitation of special needs patients under general anesthesia is safe. While morbidity is very low, larger studies are needed to establish risk versus benefit stratification among this patient population.
我们评估了全身麻醉用于特殊需求患者牙科治疗的安全性,该安全性与美国麻醉医师协会身体状况(ASAPS)分类、手术过程及其他因素相关。经过机构审查委员会的审查和批准,对5年内因全身麻醉在门诊外科手术室接受综合牙科康复(CDR)的特殊需求患者的病历进行回顾性评估,以确定与麻醉和手术相关的术中及术后并发症。所有记录由一名独立评估员进行评估,该评估员将患者的年龄、性别、ASAPS分类及手术时长制成表格。N = 363,平均年龄 = 46.93 +/- 16.835岁,年龄中位数 = 48岁,男性患者 = 180例,女性患者 = 183例,ASAPS I级 = 183例,ASAPS II级 = 127例,ASAPS III级 = 53例,手术平均时长 = 140.631 +/- 23.104分钟,手术时长中位数 = 142.000分钟,并发症数量 = 2例。一例并发症发生在一名16岁的ASAPS I级男孩身上,与气道相关;另一例发生在一名22岁的ASAPS III级女性身上,与手术相关。两例均导致非计划住院,并成功治愈,无残留后遗症。全身麻醉下特殊需求患者的牙科康复是安全的。虽然发病率很低,但需要更大规模的研究来确定该患者群体的风险与获益分层。