Faculty of Dentistry, Ankara University, Ankara, Turkey.
Pediatr Dent. 2023 Nov 15;45(6):511-519.
The purposes of this retrospective study were to investigate the incidence of cardiac and respiratory complications in pediatric patients undergoing dental procedures with deep propofol sedation and examine the factors that may lead to the development of these complica- tions. This study was carried out using the records of 421 pediatric patients who received dental treatment with deep sedation. Previously recorded cardiac/respiratory complications were noted. In addition, factors such as age, gender, body mass index (BMI), propofol induction/ infusion/total dose, operation duration, and the presence of comorbidities, which were investigated whether they affect these complications, were also noted. Data were analyzed with Mann-Whitney U, chi-square, and Fisher exact tests using univariable and multivariable logistic regression analyses. A level of five percent was considered to indicate statistical significance. There were no significant differences between the cases with and without complications in terms of gender, age, BMI, total propofol dose, and operation time (P=0.887, P=0.827, P=0.213, P=0.581, and P=0.081, respectively). According to the multivariable logistic regression analysis, trisomy 21, heart disease, and asthma were found to be significant risk factors for the development of these complications (odds ratios equal 9.776, 3.257, and 14.646, respectively, 95 percent confidence interval; 3.807-25.100, 1.095-9.690, 4.110-52.188, respectively). Considering the limitations of this study, to minimize cardio-respiratory complications it is recommended that patients with comorbidities should not be managed with deep sedation and an open airway.
本回顾性研究旨在调查接受深度异丙酚镇静的儿科患者在牙科手术中发生心脏和呼吸并发症的发生率,并探讨可能导致这些并发症发生的因素。该研究使用了接受深度镇静牙科治疗的 421 名儿科患者的记录。记录了先前记录的心脏/呼吸并发症。此外,还记录了年龄、性别、体重指数 (BMI)、异丙酚诱导/输注/总剂量、手术持续时间以及是否存在合并症等因素,以探讨它们是否会影响这些并发症。使用单变量和多变量逻辑回归分析,采用曼-惠特尼 U 检验、卡方检验和 Fisher 精确检验对数据进行分析。设定 5%的水平为统计学显著。
在性别、年龄、BMI、总异丙酚剂量和手术时间方面,有并发症和无并发症的病例之间无显著差异(P=0.887、P=0.827、P=0.213、P=0.581 和 P=0.081)。根据多变量逻辑回归分析,21 三体、心脏病和哮喘被发现是这些并发症发生的显著危险因素(比值比分别为 9.776、3.257 和 14.646,95%置信区间分别为 3.807-25.100、1.095-9.690 和 4.110-52.188)。
考虑到本研究的局限性,为了最大限度地减少心肺并发症,建议患有合并症的患者不应接受深度镇静和开放气道管理。