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

Abstract

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.

Effect of converting from propofol to remimazolam with flumazenil reversal on recovery from anesthesia in outpatients with mental disabilities: a randomized controlled trial

“…General anesthesia is often the only feasible option for patients with mental disabilities who have difficulty cooperating during dental treatment [ 1 , 2 ]. Since most dental treatments are typically conducted on an outpatient basis, it is crucial to ensure prompt recovery and effectively address postoperative nausea and vomiting (PONV) [ 2 , 3 ]. However, patients with mental disabilities tend to awaken slowly from general anesthesia compared with those without mental disabilities.…”