Reported anaesthetic complications during an 11‐year period. A retrospective study

Wang, L. P.; Hägerdal, M.

doi:10.1111/j.1399-6576.1992.tb03456.x

Cited by 28 publications

(24 citation statements)

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“…Although tooth injuries during endotracheal intubation are common [1,2], few articles have reported alveolar bone fractures during mechanical ventilation. In this patient, an alveolar bone fracture with tooth subluxation from the sockets probably was caused by vigorous biting on the latex bite block.…”

Section: Discussionmentioning

confidence: 98%

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Dental injury with alveolar bone fracture during mechanical ventilation: a case report

et al. 2000

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weak tension at a rate of 92 beats·min Ϫ1 . His blood pressure was 146/86 mmHg after administration of 5.1 µg·kg Ϫ1 ·min Ϫ1 of dopamine. His axillary temperature was 38.1°C. The Glasgow coma scale showed 7; eyeopening 2, verbal response 1, and motor response 4. His pupils were isocoric, round, highly reactive to light, and undilated. Cranial computed tomography revealed no pathological region except at the old cerebral infarction. There was significant jaundice on his skin and bulbar conjunctiva. The abnormal laboratory findings were as follows: total bilirubin, 3.4 mg·dl Ϫ1 ; aspartate aminotransferase, 1552 IU·l Ϫ1 ; alanine aminotransferase, 1708 IU·l Ϫ1 ; lactate dehydrogenase, 1836 IU·l Ϫ1 ; alkaline phosphatase, 290 IU·l Ϫ1 ; international normalized ratio (INR), 4.7; blood urea nitrogen, 40.9 mg·dl Ϫ1 ; serum sodium, 156 mEq·l Ϫ1 ; and serum chloride, 114 mEq·l Ϫ1 . Hepatic dysfunction was partly eased with a fresh frozen plasma infusion. Cardiac function was supported with continuous administration of dopamine.The endotracheal tube was positioned at a depth of 23 cm on the right maxillary central incisor using adhesive tape. A latex bite block was inserted between the upper and the lower teeth to avoid involuntary biting of the tube. The patient often bit on the bite block in response to endotracheal suctioning or oral cavity cleaning. At the first oral examination in the ICU on day 1, no significant dental findings were noted other than an absence of left mandibular molars. On day 3, a number of anterior teeth in contact with the bite block were noted to be mobile and elongated. A closer examination revealed incomplete dislocation of these teeth and bleeding from the gingiva (Fig. 1). Moreover, moderate mobility of the alveolar bone was detected. These findings suggested that the alveolar bone sockets were not intact and were probably fractured. However, portable radiography showed only an enlargement of the periodontal ligament space for the incisors, but did not show a fracture line. Dental treatment was performed

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Section: Discussionmentioning

confidence: 98%

“…Traumatic injuries to the teeth sometimes occur during endotracheal intubation under general anesthesia [1,2]. However, there are few reports of traumatic injuries affecting the alveolar bone in patients during respiratory management in the intensive care unit (ICU).…”

Section: Introductionmentioning

confidence: 99%

Dental injury with alveolar bone fracture during mechanical ventilation: a case report

et al. 2000

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“…In den meisten Berichten haben Verletzungen der oro-dentalen Hartund Weichgewebe zumindestens einen erheblichen Anteil an der Gesamtzahl der beobachteten narkoseassoziierten Schädigungen der Gesundheit des Patienten [35, 83,194]. Nach Ergebnissen von Wang et al (1992) sowie Utting et al (1979) haben Zahnverletzungen mit 55% bzw. 40% sogar den größten Anteil an den im Laufe von mehreren Jahren dokumentierten Narkoseschäden [191,193] (Abb.…”

Section: Oro-dentale Verletzungen Während Der Intubationsnarkoseunclassified

“…Nach Ergebnissen von Wang et al (1992) sowie Utting et al (1979) haben Zahnverletzungen mit 55% bzw. 40% sogar den größten Anteil an den im Laufe von mehreren Jahren dokumentierten Narkoseschäden [191,193] (Abb. 1).…”

Section: Oro-dentale Verletzungen Während Der Intubationsnarkoseunclassified

“…bei starker Lockerung der Frontzähne, während der unmittelbaren postoperativen Phase Zahnverletzungen zufügen [25]. Unter Berücksichtigung der exzellenten Möglichkeiten zur Korrektur dieser Schäden und im Hinblick auf den weitgehend fehlenden Einfluß dieser Traumen auf die allgemeine körperliche Gesundheit schlagen Wang et al (1992) jedoch die Einordnung von narkoseassoziierten Zahnverletzungen in der Kategorie der mittelschweren Gesundheitsschäden vor [193]. Hinweise auf orale Verletzungen durch die Verwendung von Guedel-Tuben finden sich auch bei anderen Autoren [63,167].…”

Section: Verletzungen Dentaler Hartgewebe Durch Die Intubation äTiolounclassified

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Oro-dentale Verletzungen während der Intubationsnarkose

Folwaczny

Hickel

1998

Der Anaesthesist

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Injuries to the oro-dental tissue are still one of the most frequent mishaps during endotracheal intubation and general anaesthesia. However, damage to the soft and hard tissues in most cases involves oral structures already showing advanced pathogenic alterations. Injuries to the teeth are therefore rather more often due to the disease of the teeth than to mistakes during anaesthesia. The risk of injuries to the teeth can be ascertained by means of a presurgical inspection of the oral cavity and evaluation of the individual anatomical conditions in the head and neck region, which may well interfere with the endotracheal intubation. In contrast to anaesthetic pitfalls causing severe disturbance of general health, dental trauma can be treated with quite satisfying functional and aesthetic results. However, in order to maintain conditions for the complete restitution of injured teeth immediate dental therapy is recommended. In preterm infants which need mechanical ventilation during the postnatal period direct laryngoscopy as well as mechanical alterations caused by an oral tube can cause injuries to the tooth germs of the first and second dentition and deformation of the maxillary skeleton. In consequence the patient will need intensive therapy of the resulting disturbances for several years. This review gives information about the causes and types of injuries to the oral and maxillofacial region during general anaesthesia. In addition, the anatomical conditions and pathological changes associated with an increased risk for oro-dental injuries and the facilities for prevention are discussed. Finally, the main aspects of emergency treatment of injuries to the dental hard tissues are presented.

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Perioperative dental injury at a tertiary care health system: An eight‐year audit of 816,690 anesthetics

Vallejo

Best

Phelps

et al. 2012

J of Healthc Risk Manag

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Among all complications of airway management, dental injury is the most common cause of patient complaints with medicolegal consequences. Over an 8-year period, data on dental injury were collected within a large university hospital system that included community, tertiary, and quaternary care centers. Patient characteristics were compared among all patients receiving anesthesia care using billing data collected from the same period. Of the 816,690 patients who received anesthesia care, there were 360 dental injuries, giving an overall incidence of 1:2,269 (0.044%). Patients receiving general anesthesia were at an increased risk for dental injuries, with an incidence of 1:1,754 (0.057%) compared with patients receiving monitored anesthesia care in whom the incidence was 1:12,500 (0.008%). Patients in the age group 18 to 65 years had a higher incidence of dental injuries of 1:1,818 (0.055%) compared with pediatric patients, who had an incidence of 1:7,692 (0.013%). Emergency procedures were not associated with an increased risk of dental injury in the 816,690 cases. However, of the 360 patients who sustained a dental injury, emergency procedures were associated with a higher incidence of injuring multiple teeth.

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Reported anaesthetic complications during an 11‐year period. A retrospective study

Cited by 28 publications

References 20 publications

Dental injury with alveolar bone fracture during mechanical ventilation: a case report

Dental injury with alveolar bone fracture during mechanical ventilation: a case report

Oro-dentale Verletzungen während der Intubationsnarkose

Perioperative dental injury at a tertiary care health system: An eight‐year audit of 816,690 anesthetics

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