A frightening complication of general anaesthesia for paediatric dental extractions

Abstract

We report a case of eight year old child who developed severe subcutaneous emphysema, bilateral pneumothorax, pneumomediastinum and pneumoperitonium in recovery room after apparently uneventful general anaesthesia for eight primary teeth extractions. Causes and treatment of these complications are discussed.

Cervicofacial subcutaneous emphysema and pneumomediastinum after retinal detachment surgery: just another monitored anesthesia eye case

“…Another case report, presented at an international ophthamology meeting in 2009, described the occurrence of SQ emphysema of the head, face, and neck following vitrectomy for a vitreous hemorrhage. 1 The situation was suggestive of an occurrence similar to what was experienced in this case. Pressurized air forced from the vitreous cavity through the retinal and globe perforations, into the periorbital space was offered as the causative mechanism.…”

“…Subcutaneous emphysema may result from traumatic injury such as a tracheal-bronchial rupture, barotrauma, the pathologic process of gas producing micro-organisms, the physiologic alteration of decompression sickness, or as an iatrogenic complication resulting from a clinical procedure [1]. Subcutaneous emphysema as an iatrogenic etiology is a rare, yet potentially serious and lifethreatening occurrence [2].…”

Subcutaneous emphysema following dental care of a patient with ventriculoperitoneal shunt: Case report

“…In the articles reviewed, there was no significant correlation when comparing oral versus nasal endotracheal intubation in the development of SE during dental procedures. There was an association between increasing procedural time and progression of SE 3,10–13,19–21 …”

Evaluation of Dental Treatments Under General Anesthesia in Aged 1-12 Years Children: A Retrospective Study

“…7,8 Yapılan çalışmalarda, günübirlik genel anestezi operasyonu geçiren hastalarda daha az oranda mortalite görüldüğü bildirilmektedir. 9 Miyokardiyal enfeksiyon, pulmoner emboli, serebrovasküler bozukluklar, solunum problemleri, hemoraji, malign hipertermi gibi istenmeyen majör komplikasyonlar ile özellikle çocuklarda operasyon sonrası yemek yemede zorlanma (%86), uyuklama (%71), dental ağrı (%48), dental hemoraji (%40), boğaz ağrısı (%35), kusma (%26), ateş (%21), öksürük (%12) ve bulantı (%8) en sık karşılaşılan problemlerdir. Şikâyetlerin büyük ölçüde postoperatif 3. günde azaldığı belirtilmiştir.…”