Summary Trial/Special Care Dentistry
Evidence-Based Dentistry (2006) 7, 37. doi:10.1038/sj.ebd.6400408
Sevoflurane or halothane could be used for intellectually disabled children under day-stay general anaesthesia
Is there any difference in postoperative morbidities for 24 h following dental care under day-stay general anaesthesia using sevoflurane or halothane in intellectually disabled children?
Address for correspondence: Dr Ersin, Ege University Dental Faculty, Department of Pedodontics, 35100 Bornova-Izmir, Turkey. E-mail: nazan@dent.ege.edu.tr.
Avril Macpherson1
1Special Care and Sedation Department, Lothian Salaried Primary Care Dental Service, Edinburgh, Scotland, UK
Ersin NK, Önçag O, Cogulu D, Çiçek S, Balcioglu ST, Çökmez B. Postoperative morbidities following dental care under day-stay general anaesthesia in intellectually disabled children. J Oral Maxillofac Surg 2005; 63:1731–1736
Abstract
Design
This reports on a randomised controlled trial conducted in Turkey.
Intervention
Children were recruited to the trial who had intellectual disabilities and who underwent general anaesthesia for their dental treatment. Anaesthesia was randomly assigned to be maintained with sevoflurane (2.0–3.0%) or halothane (1.0–1.5%) after participants received inhalation induction either with sevoflurane (8.0%) or halothane (5.0%) and nitrous oxide in oxygen (50:50). Immediately after induction, a suppository of diclofenac was given to all patients. The children also received fentanyl, atropine and atracurium besylate intravenously.
Outcome measures
The time required for recovery (measured using the Aldrete Scale) and the length of time taken before they were discharged (the postanaesthetic discharge scoring system) from the hospital were noted. Pain and agitation were recorded using a visual analogue scale (0 to 10). Other postoperative morbidities, including crying, nausea and vomiting, bleeding and drowsiness, were also noted for 24 h after the operation.
Results
A total of 86 intellectually disabled children were recruited. Forty-two children received sevoflurane whereas 44 received halothane. The most common morbidities during the postoperative 24 h were agitation and pain, and their occurrence was significantly more common in the sevoflurane group than in the halothane group (P<0.05). The recovery time was shorter in the sevoflurane group, but the difference was not statistically significant. There was no difference between the groups in the discharge time.
Conclusions
Apart from more postoperative agitation and pain after awakening from sevoflurane, the quality of recovery was similar between sevoflurane and halothane in the recovery room and at home during the first 24 h.
