Postoperative Discomfort of Dental Rehabilitation under General Anesthesia

Abstract

Objective: To find out postoperative discomfort in children undergoing dental rehabilitation under general anesthesia (DRGA). Methods: This study involved 78 (4 to 10 year-old) healthy patients who were scheduled for DRGA and were needed extensive dental treatment because of severe caries, and showed high dental fear and/or behavioral management problems. The children had to be fit for DRGA administration by fulfilling the American Society of Anesthesiologists physical status I or II and no associated mental health or communication problems. Data were collected by structured interview either face to face (immediately post operation) or using a telephone (post operation after discharge). One of the study’s investigators recorded all data related to the immediate postoperative period during the child’s stay in the post-anesthesia care unit (PACU). The questionnaire consisted of questions related to postoperative problems experienced by the patient in the period after their day-stay attendance. The questionnaire, consisting of questions regarding and generally related to the child’s activities. In addition, pain was assessed using the face, legs, activity, cry, consolability (FLACC) scale. Results: The prevalence of postoperative problems was 46 out of 78 (59%). The mean FLACC score was 1.8 (SD=2.1). Some of the patients having more than one reported problem. Forty-one percent of the children showed nasal discomfort (P<0.01). Thirty-three percent and 43% of the children experienced throat or mouth discomfort. The most common experienced postoperative symptom after DRGA was bleeding. Nasal bleeding, however, was an uncommon complication and did not cause serious morbidity or mortality in children intubated nasotracheally. In addition, postoperative discomfort was related to number of the extractions. Children who had 4 or more extractions were more likely to experience pain. Findings associated with other bodily functions were assessed. Nausea and vomiting were reported in 20.5% of children. Twenty-six children (18%) had a fever. Thirty-nine (50.0%) parents reported that their children had problems eating. Conclusion: Post-operative discomfort was more with 4 or more extraction done under DRGA and that nasal bleeding was noted a uncommon post-operative symptom.

Different Aspects of General Anesthesia in Pediatric Dentistry: A Review

“…Under GA all required treatments are performed in a single session in a hospital environment providing efficient services in a safe mode ( 4 , 8 , 15 ). Moreover, GA is one modality to ensure that the child received effective pain control ( 9 ).…”

“…Most of pediatric patients report complaints following dental GA procedure in different severity ( 23 ). Dental pain, difficulty in eating, nasal bleeding, throat discomfort, nose discomfort, sleep alteration, weakness, drowsiness, dehydration, fever, nausea, vomiting, hoarseness, diarrhea and constipation are several reported postoperative discomforts ( 8 , 23 ). Post-operative pain is the most common complaint reported ( 23 ).…”

“…These children are not suitable candidates for conventional in-office treatments and are more safely and effectively treated under GA ( 9 ). The majority of dental GA candidates are children who suffer from one prevalent health problem, early childhood caries (ECC), and are otherwise healthy ( 2 , 8 , 11 - 16 ).…”

The Papoose Boar apoose Board: Parents’ P ents’ Perceptions and A ceptions and Attitudes of Its ttitudes of Its Usage in Their Child’s Dental Treatment

“…Pediatric patients that undergo dental treatment under GA often complain of post-operative complications, which include dental pain, difficulty in eating, nasal bleeding, throat discomfort, nose discomfort, sleep alteration, weakness, drowsiness, dehydration, fever, nausea, vomiting, hoarseness, diarrhea, and constipation. [17][18][19] PB might provide a better option than other dental treatments as it is cost-effective, helps stabilize and calm patients, and reduces complications and risks during dental treatment. 20 Our findings showed that 63.2% of respondents agreed that PB was an effective behavioral management technique.…”

The postoperative discomfort inventory: A psychometric analysis

“…Postoperative patient discomfort differs with the type of surgery. In oral surgery, discomfort has been extensively taken into account as a component of good outcome, for example, in root canal surgery, [10][11][12][13][14][15][16][17] orthodontic procedures, [18] third molar surgery, [19][20][21][22] treatment of caries, [23,24] soft-tissue surgery, [25] and frenectomy. [26] In some surgical procedures, pain is not the main disturbing postoperative symptom.…”