Onçağ Ozant, Aydemir Söhret, Ersin Nazan, Koca Hüseyin
Department of Pedodontics, Faculty of Dentistry, Ege University, Izmir, Turkey.
Congenit Heart Dis. 2006 Sep;1(5):224-8. doi: 10.1111/j.1747-0803.2006.00039.x.
The aim of this study was to assess the incidence of bacteremia from various procedures in children undergoing dental treatment under general anesthesia.
Three blood samples for cultures were obtained from each patient; the first sample (10 ml basal) at the onset of the process and the second sample (10 ml) within 30 seconds following the nasotracheal intubation. The third blood sample (10 ml) was taken 30 seconds after the extraction of a deciduous tooth or a permanent tooth or slow drilling. Following incubation in an automated blood culture system, bacteria were identified by using conventional biochemical methods and commercial identification systems. Chi-square test was used to assess the findings statistically.
All blood cultures were negative before intubation (baseline) in every patient. However, the percentage of positive samples in deciduous tooth extraction and permanent tooth extraction groups were 18/26 (69.2%) and 18/25 (72%), respectively. These values were significantly greater than the results of baseline 0/74 (0%), slow drilling 3/23 (13%), and nasotracheal intubation 9/74 (12.3%) (P < .05).
Consequently, the patients treated under dental general anesthesia have to be evaluated with detailed physical examination and antibiotic prophylaxis should be given if required in order to prevent further unexpected bacterial endocarditis.
本研究旨在评估在全身麻醉下接受牙科治疗的儿童进行各种操作后菌血症的发生率。
从每位患者采集三份用于培养的血样;第一份样本(10毫升基础样本)在操作开始时采集,第二份样本(10毫升)在经鼻气管插管后30秒内采集。第三份血样(10毫升)在乳牙或恒牙拔除或慢速钻孔后30秒采集。在自动血培养系统中孵育后,使用传统生化方法和商业鉴定系统鉴定细菌。采用卡方检验对结果进行统计学评估。
每位患者插管前(基线)所有血培养均为阴性。然而,乳牙拔除组和恒牙拔除组的阳性样本百分比分别为18/26(69.2%)和18/(72%)。这些值显著高于基线0/74(0%)、慢速钻孔3/23(13%)和经鼻气管插管9/74(12.3%)的结果(P <.05)。
因此,接受牙科全身麻醉治疗的患者必须进行详细的体格检查评估,如有需要应给予抗生素预防,以防止进一步发生意外的细菌性心内膜炎。