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Reducing general anaesthetic episodes: ‘piggyback' procedures - Birmingham Children's Hospital experience

British Dental Journal (2024)Cite this article

Abstract

Introduction Birmingham Children's Hospital (BCH) has a well-established care pathway for joint procedures - ‘piggybacks' - under general anaesthetic (GA). The premise behind these joint procedures is that dental treatment is undertaken at the same time as another planned GA, usually completed by the patient's primary medical or surgical specialty, or another speciality attending a dental GA list.

Aim The aim of this paper is to share the recent BCH experience of joint procedures and provide a model for secondary and tertiary care providers across the UK to develop their own collaborative working approaches.

Method Data were collected retrospectively from May 2021 to May 2023 on the department of paediatric dentistry at Birmingham Children's Hospital. Patients were included if they had any joint procedure undertaken.

Results In total, 93 patients were treated as a ‘piggyback' procedure during this period. The average age of patient treated was nine years and three months. A total of 39 patients had extractions only during this period, while 19 had scaling only and 12 had both scaling and extractions. Additionally, 269 primary teeth and 22 permanent teeth were extracted during this period.

Conclusion BCH has a well-established pathway of care for ‘piggyback' procedures. Future workforce planning and patient care pathways should consider joint procedures and further explore this initiative to continue to streamline patient care and reduce waiting lists and risks associated with GA.

Key points

  • Provides an insight into the current practice of ‘piggyback' procedures at Birmingham Children's Hospital.

  • Discusses transferable collaborative working approaches which help reduce waiting lists and risks associated with general anaesthetic.

  • Raises awareness of the possibility of joint procedures and the likelihood of these being possible.

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Acknowledgements

The authors would like to acknowledge Fionnuala Loy for her assistance with a portion of the data collection. The authors would further like to thank all the staff at BCH for their commitment to collaborative working and ongoing accommodation of ‘piggyback' procedures.

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Authors and Affiliations

  1. Consultant in Paediatric Dentistry, Birmingham Dental Hospital, 5 Mill Pool Way, Birmingham, B5 7EG, UK

    Nabeel Ilyas

  2. Consultant in Paediatric Dentistry, Birmingham Children´s Hospital, Steelhouse Lane, Queensway, Birmingham, B4 6NH, UK

    Sarah J. McKaig

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  1. Nabeel Ilyas
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  2. Sarah J. McKaig
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Contributions

Nabeel Ilyas and Sarah J. McKaig both contributed equally to the conception, data analysis, drafting and revision of the manuscript.

Corresponding author

Correspondence to Nabeel Ilyas.

Ethics declarations

The authors declare no conflict of interest. This project was registered as a service evaluation within Birmingham Children's Hospital - as it evaluated existing data, it therefore did not require ethical approval. Consent to participate was not required for retrospective data collection.

Data availability

Data available upon request.

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Ilyas, N., McKaig, S. Reducing general anaesthetic episodes: ‘piggyback' procedures - Birmingham Children's Hospital experience. Br Dent J (2024). https://doi.org/10.1038/s41415-024-7349-0

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