Ciccozzi Alessandra, Lupi Ettore, Necozione Stefano, Giovannetti Filippo, Oliva Antonio, Ciuffini Roberta, Angeletti Chiara, Marinangeli Franco, Piroli Alba
Department of Life, Health and Environmental Sciences (MeSVA), University of L'Aquila, 67100 L'Aquila, Italy.
San Salvatore Teaching Hospital of L'Aquila, 67100 L'Aquila, Italy.
Reports (MDPI). 2024 Sep 17;7(3):79. doi: 10.3390/reports7030079.
The definition of patients with special needs (SNs) is used in the literature to refer to individuals with mental and physical disorders for whom the usual perioperative pathways are not applicable due to lack of cooperation, regardless of age. Studies in the literature recognize the appropriateness of general anesthesia for performing day surgery dental care in this type of patient.
The main objective was to assess the possible incidence of difficult airway management, understood as difficulty ventilating and/or intubating the patient. A secondary objective was to highlight the influence of general anesthesia on patient outcomes by testing the incidence of perioperative complications.
The present retrospective, single-center, observational study involved 41 uncooperative patients aged between 3 and 17 undergoing dental surgery under general anesthesia. Data relating to airway management and general anesthesia present in the medical records were analyzed.
Tracheal intubation was successfully completed in all of the patients considered, and in no case did the patient have to be woken up because of difficulty in airway management. No perioperative complications attributable to anesthesia were found in any patients.
From the present experience, it can be concluded that general anesthesia is a suitable option for performing dental care in pediatric subjects with special needs, and that although the peculiar perioperative management of these patients might increase the risk of possible anesthesia-related side effects, no complications have been encountered in any case.
文献中对特殊需求患者(SNs)的定义是指患有精神和身体疾病、因缺乏合作而常规围手术期路径不适用的个体,年龄不限。文献研究认可全身麻醉用于这类患者进行日间手术牙科护理的适宜性。
主要目的是评估困难气道管理的可能发生率,即患者通气和/或插管困难。次要目的是通过检测围手术期并发症的发生率来突出全身麻醉对患者结局的影响。
本回顾性、单中心、观察性研究纳入了41例年龄在3至17岁之间、在全身麻醉下接受牙科手术的不合作患者。分析了病历中与气道管理和全身麻醉相关的数据。
所有纳入患者均成功完成气管插管,无一例因气道管理困难而必须唤醒患者。任何患者均未发现可归因于麻醉的围手术期并发症。
根据目前的经验,可以得出结论,全身麻醉是为有特殊需求的儿科患者进行牙科护理的合适选择,尽管这些患者特殊的围手术期管理可能会增加麻醉相关副作用的风险,但在任何情况下均未遇到并发症。