Pediatric tooth extractions under sedoanalgesia

Abstract

Objective:The present study aims to evaluate intravenous ketamine and inhalation sedation in children, their unwanted side-effects and surgeon satisfaction.Methods:In this study, data of 922 children aged between 1-18 who underwent tooth extraction under sedoanalgesia in our department between September 2015-January 2016 were gathered and anesthesia approaches, unwanted side effects and surgical satisfaction was investigated. Postoperative recovery emergence agitation or delirium was evaluated with Watcha Behavior Scale (WBS).Results:Patients were grouped and compared according to acceptance of intravenous line placement (Group-1) or not (Group- 2). Group 1 received intravenous ketamine anesthesia (n=822), Group 2 received inhalation anesthesia with sevoflurane (n=100). Number of patients, age, weight and gender was significantly different in two groups. When side effects were investigated nausea was observed in 30 patients (3.6%), skin rashes were observed in 26 patients (3.2%) in Group-1 while skin rashes were observed in one patient (1%) in Group 2. 95% of surgeons reported intravenous anesthesia, 18% of surgeons reported inhalation anesthesia to be the anesthesia of choice. Emergence of postoperative recovery agitation (WBS≥3) was observed more frequent in Group 2 (p<0.05) than Group 1.Conclusion:Ketamine, which has analgesic, hypnotic and amnestic effects and which does not alter pharyngeal and laryngeal reflexes thus minimizes aspiration possibility, is a safe and effective anesthetic agent for tooth extractions of the pediatric population under sedoanalgesia.

A comparison of ketamine-midazolam combination and propofol-fentanyl combination on procedure comfort and recovery process in pediatric colonoscopy procedures

“…Arpaci et al also compared ketamine and inhaler anesthesia for sedoanalgesia during tooth extraction in children. 24 The authors emphasized that ketamine is an amnestic, analgesic, hypnotic effective and safe agent, without altering pharyngeal and laryngeal reflexes, minimizing the possibility of aspiration during the procedure. They stated that ketamine may be preferred over other agents for pediatric sedoanalgesia.…”

Anesthetic Management of a Patient with Pompe Disease: Our Experiment

“…With the combination of ketamine and infiltrational anesthetics, which we prefer because of the possibility of malignant hyperthermia and presence of hypertrophic cardiomyopathy. With ketamine's analgesic, hypnotic and amnestic effects, it doesnt surpress pharyngeal and laryngeal reflexes, does not cause cardiovascular and respiratory depression (3,4,6) We believe that we have performed the procedure without side effects, without the need for additional anesthetic stabilization.…”

Ağız Diş Çene Cerrahisinde Sedasyon Uygulamaları ve Diş Çekimlerinin Retrospektif Olarak Değerlendirilmesi

“…Dental anksiyete ve diş hekimi korkusuna sahip çocuklarda rutin diş hekimi kontrolleri yapılamamakta ve çürük insidansı daha yüksek olmaktadır. Ayrıca, sadece diş ağrısı ve apse gibi acil durumlarda diş hekimine gidildiği için koruyucu diş hekimliği uygulama basamakları atlanmakta ve erken diş çekimlerinde artışa neden olmaktadır (4). Genel anestezi işlemleri kendi içerisinde bilinçli sedasyondan, havayolunun mutlak suretle kontrol altına alınmasının zorunlu olduğu, solunumun tamamen gittiği tüm işlemleri kapsayan genel bir durumu ifade eder.…”

“…Genel anestezi işlemleri kendi içerisinde bilinçli sedasyondan, havayolunun mutlak suretle kontrol altına alınmasının zorunlu olduğu, solunumun tamamen gittiği tüm işlemleri kapsayan genel bir durumu ifade eder. İleri dental tedavilerin ve cerrahilerin planlanmadığı sadece diş çekimi yapılan, hava yolunu tehlikeye sokmayacak ve işlem süresinin 30 dakikayı geçmediği hastalarda fizyolojik reflekslerin korunduğu, hastanın fiziksel ve sözlü uyaranlara cevap verebildiği bilinçli sedasyon tercih edilmektedir (4,5). Retrospektif olarak planlanan bu çalışmanın amacı sağlıklı çocuk hastalarda sedasyon ile yapılan diş çekimlerinin değerlendirilmesidir.…”