Genel Anestezi Altında Diş Tedavisi Sonrası Hastaların Postoperatif Konforunun Değerlendirilmesi

Yıl 2021, Cilt: 3 Sayı: 1, 7 - 13, 30.04.2021

Pinar Demir , Sacide Duman , Uğur Akdağ , Osman Saraç Gülsüm Duruk

Öz

Amaç: Postoperatif konforun kapsamlı bir şekilde değerlendirilmesi ve iyileştirilmesi, çocukların gelecekteki diş fobisinin üstesinden gelmek için önemlidir. bu çalışmanın amacı genel anestezi altında dental tedavi sonrası; postoperatif ağrı ve komplikasyonların dental prosedürlerle ilişkisini FLACC ağrı değerlendirme skalasıyla incelemektir.
Yöntemler: Çalışmaya 3-8 yaş arası sağlıklı, kooperatif olmayan çocuklar dahil edildi. Sistemik ya da genetik hastalığı olan çocuklar ve mental retarde çocuklar çalışma dışı tutuldu. Hastaların demografik bilgileri, diş tedavileri, ameliyat süreleri ve ameliyat sonrası konforu kaydedildi. Hastaların ameliyat sonrası konforları diş hekimi tarafından FLACC skalası ile değerlendirildi. Hastaların FLACC skorları (0, 20, 40, 60 ve 120. dakika) ve postoperatif komplikasyonları (0, 60, 120, 240 dakika) kaydedildi.
Bulgular: Hastaların ortalama yaşı 5.23 (±2.24) operasyon süresi 98.43 (±31.5) dakika ve çekilen diş sayısı 1.15 (±1.23)'dir. Postoperatif ağrıyı takiben en sık komplikasyonlar sırasıyla; %52.05 ile boğaz ağrısı, %50.68 ile bulantı, %41.09 ile oral kanama ve %24.65 ile uyuklamadır. En az görülen komplikasyonlar %12.32 ile ateş ve %13.69 ile nazal kanama olmuştur. FLACC skoru 4 ve üzeri olan hasta yüzdesi % 63.01’dir. Operasyon süresi uzadıkça ( >90 dakika) ve çekilen diş sayısı ( >4) arttıkça hastanın postoperatif konforunun azaldığı görüldü.
Sonuçlar: FLACC skorlamasının yeterli olduğu ve skalanın içerdiǧi kriterlerin kullanımı ile postoperatif konforun objektif şekilde değerlendirildiği görülmüştür.

Anahtar Kelimeler

Dental genel anestezi, diş tedavisi, FLACC, postoperatif hasta konforu, dental anksiyete.

Destekleyen Kurum

inönü üniversitesi bilimsel araştırma projeleri (BAP)

Proje Numarası

TSG-2019-1619

Evaluation of Postoperative Comfort of Patients After Dental Treatment Under General Anesthesia

Öz

Objective: Comprehensive evaluation and improvement of postoperative comfort is important to overcome children's future dental phobia. The aim of this study is after dental treatment under general anesthesia; To examine the relationship between postoperative pain and complications with dental procedures using the FLACC pain assessment scale.
Methods: Healthy non-cooperative children aged 3-8 years were included in the study. Children with systemic or genetic diseases and children with mental retardation were excluded from the study. Demographic information, dental treatments, operation times and postoperative comfort of the patients were recorded. Postoperative comforts of the patients were evaluated with FLACC scale by the dentist. The patients' FLACC scores (0, 20, 40, 60 and 120 minutes) and postoperative complications (0, 60, 120, 240 minutes) were recorded.
Results: The mean age of the patients is 5.23 (±2.24), the operation time is 98.43 (±31.5) minutes and the number of extracted teeth is 1.15 (± 1,23). Following postoperative pain, the most common complications are; Sore throat (52.05%), nausea (50.68%), oral bleeding (41.09%) and drowsiness (24.65%). The least common complications were fever (12.32%) and nasal bleeding (13.69%). The percentage of patients with a FLACC score of 4 and above is 63.01%. It was observed that the postoperative comfort of the patient decreased as the operation time extended ( > 90 minutes) and the number of extracted teeth ( > 4) increased.
Conclusions: It was observed that FLACC scoring was sufficient and postoperative comfort was evaluated objectively by using the criteria included in the scale.

Anahtar Kelimeler

Dental general anesthesia, dental treatment, FLACC, postoperative patient comfort, dental anxiety

Proje Numarası

TSG-2019-1619

Kaynakça

• Referans1. Saxena D, Li Y, Caufield PW. Identification of unique bacterial gene segments from Streptococcus mutans with potential relevance to dental caries by subtraction DNA hybridization. J Clin Microbiol. 2005;43(7):3508-11.
• Referans2. Jamieson WJ, Vargas K. Recall rates and caries experience of patients undergoing general anesthesia for dental treatment. Pediatr Dent. 2007;29(3):253-7.
• Referans3. Jälevik B, Klingberg G. Dental treatment, dental fear and behaviour management problems in children with severe enamel hypomineralization of their permanent first molars. Int J Paediatr Dent. 2002;12(1):24-32.
• Referans4. Dentistry AAoP. Clinical guideline on the elective use of minimal, moderate, and deep sedation and general anesthesia for pediatric dental patients. Pediatr Dent. 2004;26(7 Suppl):95.
• Referans5. Cantekin K, Yildirim MD, Cantekin I. Assessing change in quality of life and dental anxiety in young children following dental rehabilitation under general anesthesia. Pediatr Dent. 2014;36(1):12E-7E.
• Referans6. Hu Y-H, Tsai A, Ou-Yang L-W, Chuang L-C, Chang P-C. Postoperative dental morbidity in children following dental treatment under general anesthesia. BMC oral health. 2018;18(1):84.
• Referans7. Enever G, Nunn J, Sheehan J. A comparison of post‐operative morbidity following outpatient dental care under general anaesthesia in paediatric patients with and without disabilities. Int J Paediatr Dent. 2000;10(2):120-5.
• Referans8. Farsi N, Ba'akdah R, Boker A, Almushayt A. Postoperative complications of pediatric dental general anesthesia procedure provided in Jeddah hospitals, Saudi Arabia. BMC oral health. 2009;9(1):1-9.
• Referans9. Atan S, Ashley P, Gilthorpe M, Scheer B, Mason C, Roberts G. Morbidity following dental treatment of children under intubation general anaesthesia in a day‐stay unit. Int J Paediatr Dent. 2004;14(1):9-16.
• Referans10. Needleman HL, Harpavat S, Wu S, Allred EN, Berde C. Postoperative pain and other sequelae of dental rehabilitations performed on children under general anesthesia. Pediatr Dent. 2008;30(2):111-21.
• Referans11. Okyay RD, Ayoğlu H. Çocuklarda Postoperatif Ağrı Yönetimi. Pediatr Pract Res.2018;6(2):16-25. Referans12. Andersen RD, Langius-Eklöf A, Nakstad B, Bernklev T, Jylli L. The measurement properties of pediatric observational pain scales: A systematic review of reviews. IJNS. 2017;73:93-101.
• Referans13. Şen E, Arslan AM. Ürolojik cerrahi geçiren çocuklarda postoperatif ağrı ve analjezik ihtiyacının flacc skoruna göre değerlendirilmesi: retrospektif gözlemsel çalışma. Genel Tip Derg. 2020;30(3).
• Referans14. Olsson E, Ahl H, Bengtsson K, Vejayaram DN, Norman E, Bruschettini M, et al. The use and reporting of neonatal pain scales: a systematic review of randomized trials. Pain. 2021;162(2):353.
• Referans15. Yılmaz MZ, Türer A, Sümer M. Diş Hekimliği Pratiğinde Genel Anestezi: Derleme. Düzce Tıp Fak Derg. 2012;15(1):68-72.
• Referans16. Voepel-Lewis T, Shayevitz JR, Malviya S. for Scoring Postoperative Pain in Young Children. Pediatr Nurs. 1997;23(3).
• Referans17. Astuto M, Rosano G, Rizzo G, Disma N, Di Cataldo A. Methodologies for the treatment of acute and chronic nononcologic pain in children. Minerva Anestesiol. 2007;73(9):459-65.
• Referans18. Beltramini A, Milojevic K, Pateron D. Pain assessment in newborns, infants, and children. Pediatr Ann. 2017;46(10):e387-e95.
• Referans19. Cantekin K, Yildirim MD, Delikan E, Çetin S. Postoperative discomfort of dental rehabilitation under general anesthesia. Pak J Med Sci. 2014;30(4):784.
• Referans20. Ali M, Amro M, Hammuda AA. Local Anesthesia Effects on Postoperative Pain After Pediatric Oral Rehabilitation Under General Anesthesia. Pediatr Dent. 2019;41(3):181-5.
• Referans21. Ersin NK, Önçaǧ Ö, Cogulu D, Çiçek S, Balcıoǧlu ST, Çökmez B. Postoperative morbidities following dental care under day-stay general anesthesia in intellectually disabled children. J Oral Maxillofac Surg. 2005;63(12):1731-6.
• Referans22. Almaz ME, Oba AA, Sonmez IS. Postoperative morbidity in pediatric patients following dental treatment under general anesthesia. Eur Oral Res. 2019;53(3):113.
• Referans23. Farsi N, Ba'akdah R, Boker A, Almushayt A. Postoperative complications of pediatric dental general anesthesia procedure provided in Jeddah hospitals, Saudi Arabia. BMC Oral Health. 2009;9:6.
• Referans24. Hong JY, Oh JI, Kim SM. Comparison of sevoflurane-nitrous oxide and target-controlled propofol with fentanyl anesthesia for hysteroscopy. Yonsei Med J. 2002;43(4):420-6.
• Referans25. Jokela RM, Kangas-Saarela TA, Valanne JV, Koivuranta MK, Ranta PO, Alahuhta SM. Postoperative nausea and vomiting after sevoflurane with or without ondansetron compared with propofol in female patients undergoing breast surgery. Anesth Analg. 2000;91(5):1062-5.
• Referans26. Malamed SF. Handbook of local anesthesia-e-book: Elsevier Health Sciences; 2014.
• Referans27. Hall C, Shutt L. Nasotracheal intubation for head and neck surgery. Anaesthesia. 2003;58(3):249-56.
• Referans28. Tintinalli JE, Claffey J. Complications of nasotracheal intubation. Ann Emerg Med. 1981;10(3):142-4.
• Referans29. Al-Bahlani S, Sherriff A, Crawford P. Tooth extraction, bleeding and pain control. J R Coll Surg Edinb. 2001;46(5):261-4.
• Referans30. Ramazani N. Different aspects of general anesthesia in pediatric dentistry: a review. Iran J Pediatr. 2016;26(2):e2613.