Dental treatment under general anesthesia in a group of patients with cerebral palsy and a group of healthy pediatric patients

Escanilla-Casal, Alejandro; Aznar-Gómez, Mirella; Viaño, José-María; López-Giménez, Ana; Rivera-Baró, Alejandro

doi:10.4317/medoral.19568

Cited by 11 publications

(7 citation statements)

References 12 publications

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“…1 Definitely, it could be a good alternative for dental treatment needs in lacking cooperative ability healthy patients, who otherwise could not be treated. 29 However, although GA is a safe procedure, negative aspects described by the patient himself and their parents, which include hunger due to fasting, eating disorders, fear or worry, and discomfort from the intravenous cannula, 30,31 must be not forgotten.…”

Section: Discussionmentioning

confidence: 99%

Comparison of hemodynamic changes with general or local anesthesia during dental treatment in pediatric patients: A prospective clinical study

Pérez‐García,

Acosta‐Ibarra,

Ruiz‐Roca

et al. 2023

Special Care in Dentistry

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Background and aimSevere hemodynamic fluctuations during dental treatment can trigger highly undesirable physical reactions. A study was made to determine whether the administration of propofol and sevoflurane contributes to the stabilization of hemodynamic parameters during dental treatment in pediatric patients versus the use of local anesthesia alone.Materials and methodsForty pediatric patients needing dental treatment were assigned to either general anesthesia with local anesthesia (study group [SG]) or local anesthesia alone (control group [CG]). Two percent sevoflurane in oxygen (100% oxygen, 5 L/min) and continuous propofol infusion (target‐controlled infusion [TCI], 2 μg/mL) were used as general anesthesia agents in SG; and 2% lidocaine with 1:80,000 adrenaline was used as local anesthesia in both groups. Heart rate, blood pressure and oxygen saturation were measured before starting dental treatment (baseline) and every 10 min during dental treatment.ResultsBlood pressure (p < .001), heart rate (p = .021) and oxygen saturation (p = .007) decreased substantially after the administration of general anesthesia. The levels of these parameters subsequently remained low and then recovered at the end of the procedure. On the other hand, the oxygen saturation values remained closer to baseline in SG versus CG. In contrast, the hemodynamic parameters experienced lesser fluctuations in CG than in SG.ConclusionsGeneral anesthesia affords more favorable cardiovascular parameters during the entire dental treatment in comparison to local anesthesia alone (blood pressure and heart rate decrease significantly and oxygen saturation proves more stable and with values closer to baseline), and allows dental treatment to be performed on healthy, lacking cooperative ability children who otherwise could not be treated with local anesthesia alone. No side effects were observed in either group.

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Section: Discussionmentioning

confidence: 99%

Comparison of hemodynamic changes with general or local anesthesia during dental treatment in pediatric patients: A prospective clinical study

Pérez‐García,

Acosta‐Ibarra,

Ruiz‐Roca

et al. 2023

Special Care in Dentistry

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“…Postoperative complications are not frequent ( 28 , 29 ) though Escamilla-Casal ( 30 ) reported a higher rate of complications (bleeding and drowsiness) in a study of children with mental disabilities. In contrast, in our postoperative analysis, over one-half of the patients in both groups showed optimum tolerance and minimum bleeding.…”

Section: Discussionmentioning

confidence: 99%

Dental treatment under general anesthesia in mentally disabled patients based on an ambulatory surgery model: A Case-control study

Márquez-Arrico¹,

Talaván-Serna²,

Silvestre³

et al. 2022

J Clin Exp Dent

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Background Mentally disabled patients commonly offer little or no cooperation in dental treatments, and general anesthesia may become necessary in such cases. The present study was to identify the most relevant factors in dental treatment under general anesthesia in disabled patients based on a Major Ambulatory Surgery (MAS) model. The study analyzes anesthetic variables and type of dental procedures carried out for disabled patients compared with controls. Material and Methods A case-control study was carried out with 574 patients (263 cases and 311 controls) subjected to dental treatment under general anesthesia in the Day Surgery Unit of Dr. Peset University Hospital (Valencia, Spain). Epidemiological, anthropometric and preoperative data (ASA score, Mallampati classification) were collected. Results Males and obesity were more prevalent among disabled patients than controls. Significant associations were found between longer surgery time, underwent thoot extraction, tartrectomy, fillings and disabled patients treated under general anesthesia. The preoperative risk scores were likewise higher in disabled patients (ASA III-IV). The duration of surgery increased with the ASA score but didn´t influence postoperative stay. Patient condition in the first 24 hours of late postoperative recovery was good in both groups. Conclusions Dental treatment based on the MAS in mentally disabled patients is effective and safe, even in individuals with a certain prior risk (ASA III). Key words: Disabled patients, ambulatory surgery, dental treatment, special needs, Major Ambulatory Surgery by general anesthesia.

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“…Cerebral palsy is a central nervous system disorder which affects movement, coordination and posture. It reflects a nonprogressive abnormality due to insult to the immature brain leading to problems related to psychomotor activity along with defects related to sensation, cognition, communication and behavioural problems [11,12]. A variety of factors have been attributed in its aetiology which include (prenatal [35%], gestational [55%] or postnatal [10%]).…”

Section: Discussionmentioning

confidence: 99%

Anaesthesia and Rehabilitative Considerations for Full Mouth Rehabilitation of Cerebral Palsy Patients: A Case Series

Bhatnagar¹

2021

OJDOH

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Cerebral Palsy (CP) is a central nervous system disorder which is caused due to damage to the developing brain usually occurring in perinatal period. There could be multifactorial etiology with various factors such as maldevelopment of the brain, perinatal stroke, prenatal infection, genetic disorder, ischemic insult in utero or prematurity, thrombophilic disorders, teratogenic exposures, multiple gestations ,maternal fever, exposure to toxins, abdominal trauma, malformation of brain structures, abnormal fetal presentation, instrument delivery, hyperbilirubinemia, meningitis, chronic lung disease, shaken baby syndrome as the possible causes. The children inflicted with CP are at a higher risk for developing oral manifestations such as Early Childhood Caries (ECC) due to poor oral hygiene, intake of soft diet, difficulty in chewing and swallowing and increased use of sugary oral medications. Behavioural challenges due to associated mental retardation demands pharmacological management under General Anaesthesia (GA) and we present a case series of successful management of Severe ECC in five children diagnosed with CP managed with full mouth rehabilitation under GA. The aim is to highlight importance of counselling, preoperative preparation of patients, surgical modalities and postoperative rehabilitation.

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Dental treatment under general anesthesia in a group of patients with cerebral palsy and a group of healthy pediatric patients

Cited by 11 publications

References 12 publications

Comparison of hemodynamic changes with general or local anesthesia during dental treatment in pediatric patients: A prospective clinical study

Comparison of hemodynamic changes with general or local anesthesia during dental treatment in pediatric patients: A prospective clinical study

Dental treatment under general anesthesia in mentally disabled patients based on an ambulatory surgery model: A Case-control study

Anaesthesia and Rehabilitative Considerations for Full Mouth Rehabilitation of Cerebral Palsy Patients: A Case Series

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