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A Review of Pediatric General Anesthesia Combination Cases in the Special Health Care Needs Population

Orellana , Colleen C
http://rave.ohiolink.edu/etdc/view?acc_num=osu1469059968

Abstract Details

2016, Master of Science, Ohio State University, Dentistry.
ABSTRACT Purpose: The study assessed postoperative complications of general anesthesia (GA) for dental procedures in children with special needs (SN). In young children, potential neuronal effects of GA indicate efforts to reduce the frequency of GA use, by combining multiple procedures under one anesthesia induction. The present analysis investigated the safety of multiple surgical procedures under GA in the pediatric SN population. Methods: Following IRB approval, 60 combined GA cases at Nationwide Children’s Hospital (NCH) were selected for retrospective review. Outcomes included postoperative complications and postoperative admission. Covariates included age, gender, American Society of Anesthesiologists (ASA) class, previous history of anesthesia, intubation type, procedures completed, total anesthesia time, and intraoperative pain medications. Data from 55 complete patient records were included in preliminary analysis analyzed using Mann-Whitney U-tests for continuous variables and Fisher’s exact test for categorical variables. Results: Of 26 boys and 29 girls (median age=59 months) undergoing a median of 3 procedures, 7 had complications including vomiting, pain, fever, and pneumonia. Four of these patients were admitted, as well as 8 patients admitted for unrelated reasons. Dental procedures involved hygiene only (n=3; 1 complication), extractions (n=33; 5 complications) and other procedures (n=18; 1 complication). Two covariates, post-anesthesia care unit (PACU) stay duration (p=0.0116), and planned admission for post-operative observation (p=0.0336) were significantly different between patients developing complications and those that did not develop complications. Admission was significantly related to ASA class (median=3 vs. 2 for outpatient cases; p=0.016). Conclusions: 7% (4/55) of patients required unplanned admissions due to postoperative complications. This rate was higher than the average, though our small sample size in this preliminary analysis was greatly limiting. The complications were significantly associated with longer duration of PACU stay (p=0.0116) as well as not having a planned admission for post-operative observation (p=0.0336), Combining additional procedures with dental under GA did not lead to any major complications. Further analysis with a larger sample size is needed to make firm conclusions.
Paul Casamassimo, DDS, MS (Committee Chair)
Ashok Kumar, DDS, MS (Committee Co-Chair)
Catherine Falitz, DDS, MS (Committee Member)
Vidya Raman , MD (Committee Member)
38 p.
Dental Care; Dentistry; Surgery
pediatric dentistry; general anesthesia; combination cases; children with special health care needs

Recommended Citations

Citations

  • Orellana , C. C. (2016). A Review of Pediatric General Anesthesia Combination Cases in the Special Health Care Needs Population [Master's thesis, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1469059968

    APA Style (7th edition)

  • Orellana , Colleen . A Review of Pediatric General Anesthesia Combination Cases in the Special Health Care Needs Population. 2016. Ohio State University, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1469059968.

    MLA Style (8th edition)

  • Orellana , Colleen . "A Review of Pediatric General Anesthesia Combination Cases in the Special Health Care Needs Population." Master's thesis, Ohio State University, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=osu1469059968

    Chicago Manual of Style (17th edition)

osu1469059968
912
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This open access ETD is published by The Ohio State University and OhioLINK.