Anesthetic management of dental procedures in patients with special needs: A retrospective analysis of 519 patients in North of Turkey

Authors : Mehmet YILMAZ, Aysun ÇAĞLAR TORUN, Burcu BAŞ, Hatice DURAN, İlyas KÖSE, Halit FURUNCUOĞLU

Pages : 213-216

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Publication Date : 2015-01-30

Article Type : Research Paper

Abstract :Special need patients have increased risk for oral diseases throughout their life. Sedation and general anesthesia is generally the preferred treatment for special needs patients though it provides optimal conditions for dental treatment. This study was aimed to describe our anesthetic experience in dental treatments of 519 special needs patients at a dental faculty in the north side of Turkey during a three-year period. The data referring to patient’s demographic information, anesthetic techniques, agents, dental treatment duration and the type of dental procedure during the period from 2009 to 2012 were retrospectively collected. All of the patients had moderate or severe intellectual disability, and not cooperating fully with dental treatment. There were for different anesthetic techniques in application: face mask, face mask combined with intravenous sedation, total intravenous anesthesia, and nasal entubating general anesthesia. Two intravenous insert ignore into journalissuearticles values(IV); anesthesic agent, Propofol insert ignore into journalissuearticles values(Propofol); and Midazolam insert ignore into journalissuearticles values(Dormicum); were used either alone or combined. Sevoflurane insert ignore into journalissuearticles values(Sevorane); was used as inhalation anesthesia and Vecuronium bromide insert ignore into journalissuearticles values(Norcuron); was used in patients that require nasal entubation. The mean age was 19 yr insert ignore into journalissuearticles values(range 3 to 81);, and males predominated females by a ratio of 271Ä248. Of 519 patients, 204 patients were ASA grade 1, 315 patients were ASA grade 2. Cognitive impairments include; Alzheimer disease insert ignore into journalissuearticles values(1 patient); and dementia insert ignore into journalissuearticles values(1 patient);. Central nervous system disorders insert ignore into journalissuearticles values(CNS); include; ataxia insert ignore into journalissuearticles values(1 patient);, autism insert ignore into journalissuearticles values(38 patients);, cerebral palsy insert ignore into journalissuearticles values(7 patients);, hydrocephaly insert ignore into journalissuearticles values(1 patient);, multiple sclerosis insert ignore into journalissuearticles values(1 patient);. Specific syndromes include; Down syndrome insert ignore into journalissuearticles values(35 patients);, Epidermolysisbullosa insert ignore into journalissuearticles values(1 patient);, Reye’s syndrome insert ignore into journalissuearticles values(1 patient);. Only minor complications such as nose bleeding, nausea/vomiting, restlessness, dizziness, shivering and desaturation insert ignore into journalissuearticles values(saturation under 90); were seen during the immediate postoperative period. A multidisciplinary approach between the dentist and anesthesiologist are important to manage successful treatment of these patients.
Keywords : Anesthetic management, Dental treatment, General anesthesia, Sedation, Patients with special needs

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