Šimunović-Erpušina Marija, Bakarčić Danko, Cicvarić Odri, Šimunović Luka, Sotošek Vlatka, Petrović Dorotea, Ivančić Jokić Nataša
Department of Pediatric Dentistry, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia.
Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia.
Medicina (Kaunas). 2024 Apr 19;60(4):668. doi: 10.3390/medicina60040668.
General anesthesia induces reversible unconsciousness, eliminating sensation and enabling painless medical procedures. Vital for dental care, it addresses patients with medical conditions, those needing extensive procedures, and those unable to cooperate due to fear. Dental care for patients with disabilities is a significant unmet need, with studies showing increased oral disease prevalence. This research aims to analyze postoperative morbidity both in healthy and disabled children undergoing dental procedures under general anesthesia. This study involved 96 children aged 3 to 15 with dental caries. Two groups were formed: the control group (CTL) (52.94%) included healthy patients requiring general anesthesia due to unsatisfactory cooperation, and the other group included children with physical or intellectual disabilities (CD) (47.96%). Postoperative complications were monitored 1 h after the procedure and 1, 3, 7, and 14 days after the procedure by contacting parents/caregivers by phone. The intensity of postoperative pain was assessed using the Wong-Baker faces pain rating scale. General anesthesia was conducted following a standardized protocol for dental procedures. CTL patients complained more often about postoperative pain 1 h after the procedure ( = 0.03). One day after the procedure, oral bleeding ( = 0.04), fever ( = 0.009), and diarrhea ( = 0.037) occurred more often in CD. In the same period, sore throat appeared more often in CTL ( = 0.036). Three days after the dental treatment, there were statistically significant increases in the occurrence of agitation ( = 0.043) and constipation ( = 0.043) in CD. Seven days later, CD demonstrated a higher occurrence of agitation ( = 0.037). According to the Wong-Baker faces pain rating scale, CTL experienced more frequent and intense pain. CD more frequently reported complications like oral bleeding, fever, and diarrhea. In contrast, the CTL group more often reported pain-related symptoms. The conclusion underscores the need for a pain control protocol for CD and emphasizes the importance of frequent monitoring to prevent unwanted consequences during tooth restoration under general anesthesia.
全身麻醉可诱导可逆性意识丧失，消除感觉并使医疗程序无痛进行。它对牙科护理至关重要，适用于有医疗状况的患者、需要进行广泛手术的患者以及因恐惧而无法配合的患者。为残疾患者提供牙科护理是一项尚未得到满足的重大需求，研究表明此类患者口腔疾病患病率更高。本研究旨在分析在全身麻醉下接受牙科手术的健康儿童和残疾儿童术后的发病率。本研究纳入了96名年龄在3至15岁、患有龋齿的儿童。分为两组：对照组（CTL）（52.94%）包括因配合不佳而需要全身麻醉的健康患者，另一组包括身体或智力残疾儿童（CD）（47.96%）。术后1小时以及术后1、3、7和14天通过电话联系家长/照顾者来监测术后并发症。使用面部表情疼痛评分量表评估术后疼痛强度。全身麻醉按照牙科手术的标准化方案进行。CTL患者在术后1小时更常抱怨术后疼痛（P = 0.03）。术后1天，CD患者口腔出血（P = 0.04）、发热（P = 0.009）和腹泻（P = 0.037）的发生率更高。同一时期，CTL患者喉咙痛的发生率更高（P = 0.036）。牙科治疗后3天，CD患者躁动（P = 0.043）和便秘（P = 0.043）的发生率有统计学意义的增加。7天后，CD患者躁动的发生率更高（P = 0.037）。根据面部表情疼痛评分量表，CTL经历的疼痛更频繁、更强烈。CD患者更频繁地报告口腔出血、发热和腹泻等并发症。相比之下，CTL组更常报告与疼痛相关的症状。结论强调了为CD患者制定疼痛控制方案的必要性，并强调了在全身麻醉下牙齿修复期间频繁监测以防止不良后果的重要性。
