Publication: Comparison of hemodynamic changes with general or local anesthesia during dental treatment in pediatric patients: a prospective clinical study
Authors
Acosta Ibarra, Johanna ; Pérez García, Silvia ; Ruiz Roca, Juan Antonio ; Añez, Cristóbal ; Gargallo Albiol, Jordi
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Facultades de la UMU::Facultad de Medicina
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Publisher
Wiley
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DOI
https://doi.org/10.1111/scd.12890Digital Object Identifier (DOI)
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info:eu-repo/semantics/article
Description
Abstract
Background and aim
Severe hemodynamic fluctuations during dental treatment can trigger highly undesirable physical reactions. A study was made to determine whether the administration of propofol and sevoflurane contributes to the stabilization of hemodynamic parameters during dental treatment in pediatric patients versus the use of local anesthesia alone.
Materials and methods
Forty pediatric patients needing dental treatment were assigned to either general anesthesia with local anesthesia (study group [SG]) or local anesthesia alone (control group [CG]). Two percent sevoflurane in oxygen (100% oxygen, 5 L/min) and continuous propofol infusion (target-controlled infusion [TCI], 2 μg/mL) were used as general anesthesia agents in SG; and 2% lidocaine with 1:80,000 adrenaline was used as local anesthesia in both groups. Heart rate, blood pressure and oxygen saturation were measured before starting dental treatment (baseline) and every 10 min during dental treatment.
Results
Blood pressure (p < .001), heart rate (p = .021) and oxygen saturation (p = .007) decreased substantially after the administration of general anesthesia. The levels of these parameters subsequently remained low and then recovered at the end of the procedure. On the other hand, the oxygen saturation values remained closer to baseline in SG versus CG. In contrast, the hemodynamic parameters experienced lesser fluctuations in CG than in SG.
Conclusions
General anesthesia affords more favorable cardiovascular parameters during the entire dental treatment in comparison to local anesthesia alone (blood pressure and heart rate decrease significantly and oxygen saturation proves more stable and with values closer to baseline), and allows dental treatment to be performed on healthy, lacking cooperative ability children who otherwise could not be treated with local anesthesia alone. No side effects were observed in either group.
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Citation
Spec Care Dentist. 2024;44:563–574
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