Clark Holly M, Saxen Mark A, Yepes Juan F, Jones James E, Vinson Laquia A, Eckert George J, Tang Qing
Dr. Clark is an associate clinical professor, the Department of Pediatric Dentistry, Riley Hospital for Children, Indiana University, Indianapolis, Indiana, USA;, Email:
Dr. Saxen is an adjunct clinical associate professor, Department of Oral Pathology, Medicine and Radiology, all IN the School of Dentistry, Indiana University, Indianapolis, Indiana, USA.
Pediatr Dent. 2019 Jan 15;41(1):52-55.
Use of general anesthesia (GA) for comprehensive dental treatment of children is an essential health benefit. Pediatric dentists utilize dentist anesthesiologists to provide GA for dental rehabilitation of severe early childhood caries. Dentist anesthesiologists deliver GA using intubated or nonintubated GA. The purpose of this study was to compare the incidence of respiratory complications when intubated versus nonintubated general anesthesia was completed by dentist anesthesiologists in a pediatric dentistry setting. The Society of Ambulatory Anesthesia (SAMBA) Clinical Outcomes Registry (SCOR) database was queried for pediatric dental GA cases completed by dentist anesthesiologists from January 1, 2010 to December 31, 2016. Logistic regression compared intubated GA versus nonintubated GA for differences in the incidence of respiratory complications. Within 9,333 cases, there were 30 incidents of laryngospasm (0.3 percent), 19 incidents of bronchospasm (0.2 percent), two incidents of hypoxia (less than 0.1 percent), and six incidents of difficult airway (0.1 percent). When intubated versus nonintubated GA was compared for respiratory complication incidence, no significant association was found (P=0.81, odds ratio equals 0.93). No significant difference was found between the incidence of respiratory complications with intubated versus nonintubated GA provided by dentist anesthesiologists.
使用全身麻醉(GA)对儿童进行全面牙科治疗是一项基本的健康福利。儿科牙医利用牙科麻醉医生为重度幼儿龋齿的牙科修复提供全身麻醉。牙科麻醉医生采用插管或非插管全身麻醉来实施全身麻醉。本研究的目的是比较在儿科牙科环境中,牙科麻醉医生完成插管与非插管全身麻醉时呼吸并发症的发生率。查询了门诊麻醉学会(SAMBA)临床结果登记处(SCOR)数据库中2010年1月1日至2016年12月31日期间牙科麻醉医生完成的儿科牙科全身麻醉病例。采用逻辑回归比较插管全身麻醉与非插管全身麻醉在呼吸并发症发生率上的差异。在9333例病例中,有30例喉痉挛事件(0.3%)、19例支气管痉挛事件(0.2%)、2例低氧事件(不到0.1%)和6例困难气道事件(0.1%)。比较插管与非插管全身麻醉的呼吸并发症发生率时,未发现显著关联(P = 0.81,优势比等于0.93)。牙科麻醉医生实施的插管与非插管全身麻醉在呼吸并发症发生率上未发现显著差异。