A Retrospective Investigation of Patient- and Procedure-Related Factors Associated with Cardiorespiratory Complications in Pediatric Dental Patients Undergoing Deep Sedation.

Pediatric dentistry Pub Date : 2023-11-15
Çağıl Vural, Merve Hayriye Kocaoğlu, Raha Akbarihamed, Akif Demirel
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Abstract

Purpose: The purposes of this retrospective study were to investigate the incidence of cardiac and respiratory complications in pediatric patients undergoing dental procedures with deep propofol sedation and examine the factors that may lead to the development of these complica- tions. Methods: This study was carried out using the records of 421 pediatric patients who received dental treatment with deep sedation. Previously recorded cardiac/respiratory complications were noted. In addition, factors such as age, gender, body mass index (BMI), propofol induction/ infusion/total dose, operation duration, and the presence of comorbidities, which were investigated whether they affect these complications, were also noted. Data were analyzed with Mann-Whitney U, chi-square, and Fisher exact tests using univariable and multivariable logistic regression analyses. A level of five percent was considered to indicate statistical significance. Results: There were no significant differences between the cases with and without complications in terms of gender, age, BMI, total propofol dose, and operation time (P=0.887, P=0.827, P=0.213, P=0.581, and P=0.081, respectively). According to the multivariable logistic regression analysis, trisomy 21, heart disease, and asthma were found to be significant risk factors for the development of these complications (odds ratios equal 9.776, 3.257, and 14.646, respectively, 95 percent confidence interval; 3.807-25.100, 1.095-9.690, 4.110-52.188, respectively). Conclusion: Considering the limitations of this study, to minimize cardio-respiratory complications it is recommended that patients with comorbidities should not be managed with deep sedation and an open airway.

对接受深度镇静的儿童牙科患者心肺并发症的患者和手术相关因素的回顾性研究。
目的:本回顾性研究旨在调查使用深度异丙酚镇静剂进行牙科手术的儿科患者中心脏和呼吸系统并发症的发生率,并研究可能导致这些并发症发生的因素。研究方法本研究使用了 421 名接受深度镇静牙科治疗的儿童患者的记录。研究人员注意到了之前记录的心脏/呼吸系统并发症。此外,还记录了年龄、性别、体重指数(BMI)、异丙酚诱导/输注/总剂量、手术持续时间和是否存在合并症等因素,以调查这些因素是否会影响这些并发症。数据分析采用 Mann-Whitney U、卡方检验和费雪精确检验,并进行单变量和多变量逻辑回归分析。统计学意义以 5% 为限。结果有并发症和无并发症的病例在性别、年龄、体重指数、异丙酚总剂量和手术时间方面无明显差异(分别为 P=0.887、P=0.827、P=0.213、P=0.581 和 P=0.081)。多变量逻辑回归分析发现,21 三体综合征、心脏病和哮喘是这些并发症发生的重要风险因素(几率分别为 9.776、3.257 和 14.646,95% 置信区间分别为 3.807-25.100、1.095-9.690、4.110-52.188)。结论考虑到本研究的局限性,为了最大限度地减少心肺并发症,建议有合并症的患者不要使用深度镇静和开放气道。
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