Hemodynamic and ventilatory changes in pediatric patients with special needs: A comparative clinical study

Abstract

Background Very limited data are available on the hemodynamic and ventilatory changes during sedation and general anesthesia using bispectral index (BIS) monitoring in intellectually disabled children. The purpose was to determine the hemodynamic and ventilatory changes after propofol and sevoflurane administration in children with special needs (CSN) versus healthy children (HC) during dental treatment. Material and Methods Forty pediatric patients needing dental treatment were allocated into two groups: children without systemic disease (healthy children [HC]) and mentally disabled children (children with special needs [CSN]). Sevoflurane in oxygen (100% oxygen, 5 l/min) and continuous propofol infusion (target-controlled infusion [TCI], 2 µg/ml) were used as sedative agents, and 2% lidocaine with 1:80,000 adrenaline was used as local anesthesia in both groups. Heart rate (HR), oxygen saturation (SaO2), respiratory rate (RR), exhaled carbon dioxide (CO2), blood pressure (BP) and bispectral monitoring (BIS) values were recorded during the entire dental treatment procedure. Results A statistically significant decrease in systolic BP, diastolic BP and RR was observed, with no significant differences between the healthy and disabled groups. In contrast, the HR and BIS values were lower in the CSN group than in the healthy patients ( p ≤ 0.05). Conclusions Patients with special needs had lower HR and BIS values than healthy patients, while BP, SaO2 and exhaled CO2 showed similar results in both groups. Key words: Bispectral index, hemodynamic changes, ventilatory changes, pediatric patients, special needs.

Sedação em crianças com deficiências no âmbito Odontológico

“…Por esse motivo, recomenda-se a inspeção da cavidade nasal. Da mesma forma, os anestesiologistas devem estar cientes de que várias síndromes congênitas podem alterar a anatomia das vias aéreas (Pérez-García et al 2022).…”

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

“…The study sample was divided into two groups: (1) general anesthesia group (study group [SG]), involving 20 patients undergoing dental treatment under general anesthesia with local anesthesia infiltration (this group was previously included in another investigation as a control group) 13 ; and (2) local anesthesia group (control group [CG]): 20 patients undergoing dental treatment with only local anesthesia infiltration.…”

Pacientes Portadores de Necessidades Especiais (PPNE) em Odontopediatria: desafios e abordagens adaptadas.

“…A abordagem odontológica à PPNE demanda cuidado, paciência, determinação e conhecimento por parte dos profissionais da área. É essencial que cada paciente seja tratado de forma adequada, a fim de evitar transtornos no consultório e minimizar a necessidade de recorrer à anestesia geral (PÉREZ-GARCÍA et al, 2022).…”