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门诊麻醉:儿科牙科患者的安全性与结局

Office-Based Anesthesia: Safety and Outcomes in Pediatric Dental Patients.

作者信息

Spera Allison L, Saxen Mark A, Yepes Juan F, Jones James E, Sanders Brian J

机构信息

Pediatric Dental Resident, Department of Pediatric Dentistry, Riley Hospital for Children/Indiana University School of Dentistry, Indianapolis, Indiana.

Adjunct Clinical Associate Professor, Department of Oral Pathology, Medicine and Radiology, Indiana University School of Dentistry, Indianapolis, Indiana.

出版信息

Anesth Prog. 2017 Fall;64(3):144-152. doi: 10.2344/anpr-64-04-05.

Abstract

The number of children with caries requiring general anesthesia to achieve comprehensive dental care and the demand for dentist anesthesiologists to provide ambulatory anesthesia for these patients is increasing. No current published studies examine the safety and outcomes of ambulatory anesthesia performed by dentist anesthesiologists for dental procedures in pediatric patients, and there is no national requirement for reporting outcomes of these procedures. In 2010, the Society for Ambulatory Anesthesia Clinical Outcomes Registry was developed. This Web-based database allows providers of ambulatory anesthesia to track patient demographics and various outcomes of procedures. Our study is a secondary analysis of data collected in the registry over a 4-year period, 2010-2014. Of the 7041 cases reviewed, no cases resulted in serious complications, including death, anaphylaxis, aspiration, cardiovascular adverse events, or neurologic adverse events. Of the 7041 cases reviewed, 196 (3.0%) resulted in a predischarge or postdischarge adverse event. The predischarge adverse event occurring with the highest frequency was laryngospasm, occurring in 35 cases (0.50%). The postdischarge adverse event occurring with the highest frequency was nausea, reported by 99 patients (5.0%). This study provides strong clinical outcomes data to support the safety of office-based anesthesia as performed by dentist anesthesiologists in the treatment of pediatric dental patients.

摘要

需要全身麻醉以获得全面口腔护理的龋齿儿童数量以及牙医麻醉师为这些患者提供门诊麻醉的需求正在增加。目前尚无已发表的研究探讨牙医麻醉师为儿科患者进行牙科手术时门诊麻醉的安全性和结果,并且对于报告这些手术的结果也没有国家要求。2010年,门诊麻醉临床结果注册中心成立。这个基于网络的数据库允许门诊麻醉提供者追踪患者人口统计学信息和手术的各种结果。我们的研究是对2010年至2014年这4年期间在该注册中心收集的数据进行的二次分析。在审查的7041例病例中,没有病例导致严重并发症,包括死亡、过敏反应、误吸、心血管不良事件或神经不良事件。在审查的7041例病例中,196例(3.0%)出现了出院前或出院后不良事件。出院前发生频率最高的不良事件是喉痉挛,有35例(0.50%)。出院后发生频率最高的不良事件是恶心,99名患者报告了这一情况(5.0%)。本研究提供了有力的临床结果数据,以支持牙医麻醉师在治疗儿科牙科患者时进行门诊麻醉的安全性。

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