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全身麻醉期间的牙齿损伤。

Teeth Damage during General Anesthesia.

作者信息

Neto João M, Teles Ana Rita, Barbosa Joselina, Santos Orquídea

机构信息

School of Dentistry, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), 4585-116 Gandra PRD, Portugal.

Department of Anesthesiology, Centro Hospitalar Universitário de São João, 4200-319 Porto, Portugal.

出版信息

J Clin Med. 2023 Aug 17;12(16):5343. doi: 10.3390/jcm12165343.

Abstract

INTRODUCTION

Dental injuries during anesthesia, especially when advanced airway management is required, represent a legal problem. Factors such as poor dental condition and excessive pressure during intubation contribute to dental damage. The maxillary central incisors are commonly affected.

OBJECTIVE

The objective of this review is to know the incidence of dental injuries in adults undergoing anesthesia that requires airway management.

MATERIALS AND METHODS

The search was performed in MEDLINE (through Pubmed), ClinicalTrials.gov, Scopus, LILACS (through the Virtual Health Library Regional Portal), and SciELO for all available literature on the subject up to December 2022. Inclusion criteria involved articles that studied patients aged 18 years or older who underwent general anesthesia requiring airway management with tracheal intubation or insertion of a laryngeal mask airway.

RESULTS

Of all the articles, nine report dental injury associated with the type of airway management. Only one article does not have dental injury.

DISCUSSION

This study addresses dental injuries related to tracheal intubation during general anesthesia. Although techniques are used to prevent them, these injuries still occur. Laryngoscopy, especially with support on the upper central incisors, can cause damage to the teeth.

CONCLUSIONS

It is important that the anesthesiologist is aware of dental trauma and that orotracheal intubation or the placement of the laryngeal mask airway is performed systematically and rigorously, always considering the patient's dentition to choose the best approach in each specific situation.

摘要

引言

麻醉期间的牙齿损伤,尤其是在需要进行高级气道管理时,是一个法律问题。牙齿状况不佳和插管时压力过大等因素会导致牙齿损伤。上颌中切牙通常受到影响。

目的

本综述的目的是了解接受需要气道管理的麻醉的成年人中牙齿损伤的发生率。

材料与方法

在MEDLINE(通过PubMed)、ClinicalTrials.gov、Scopus、LILACS(通过虚拟健康图书馆区域门户)和SciELO中进行检索,以获取截至2022年12月关于该主题的所有可用文献。纳入标准包括研究18岁及以上患者的文章,这些患者接受了需要通过气管插管或插入喉罩气道进行气道管理的全身麻醉。

结果

在所有文章中,有九篇报告了与气道管理类型相关的牙齿损伤。只有一篇文章没有牙齿损伤。

讨论

本研究探讨了全身麻醉期间与气管插管相关的牙齿损伤。尽管采用了预防技术,但这些损伤仍然会发生。喉镜检查,尤其是以上颌中切牙为支撑时,可能会导致牙齿损伤。

结论

麻醉医生了解牙齿创伤非常重要,并且口气管插管或喉罩气道的放置应系统、严格地进行,始终考虑患者的牙列情况,以便在每种具体情况下选择最佳方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd64/10456072/6b98271bf401/jcm-12-05343-g001.jpg

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