Sedation
Jeremy Coble, DDS
Pediatric Dental Resident
NYU Langone Dental Medicine, Brooklyn, NY
NYU Langone Dental Medicine, Brooklyn, NY
Anchorage, Alaska, United States
Daniel J. Kane, DMD, MA
Program Director
NYU Langone Hospitals
Brooklyn, New York, United States
David M. Okuji, DDS, MBA, MS
Senior Associate Director
NYU Langone Health
Brooklyn, New York, United States
PURPOSE: Adverse events are common during and after general anesthesia (GA) or oral conscious sedation (OCS). Therefore, this study seeks to explore hypotension in children with compared to those without lidocaine 2% 1:100,000 epinephrine local anesthetic (LA) treated under GA, the link between oxygen saturation (O2S) below 90% and children's BMI classification being treated under OCS, and post-operative pain between children who were administered lidocaine compared to articaine LA while treated under GA.
METHODS: This was a retrospective chart review of patients being treated for Early childhood caries (ECC), under 7 years old, that received dental services under GA or OCS at Alaska, Florida, and Tennessee NYU Pediatric Dental Residency sites between January 10th, 2010, to December 31st, 2020. Research methods were designed to compare prevalence of adverse events in a randomly selected pool of subjects.
RESULTS: There was one incidence of hypotension in a patient treated without LA under GA, and none in patients treated with LA (p=0.165). No patients given Articaine under GA experienced post-treatment excessive pain (0%), while 2.2% of patients who received lidocaine did (p < 0.001). Of the 19 (1.37%) who experienced O2S < 90%, 73.7% had a BMI in obesity range, 15.8% and 10.5% were in healthy and overweight ranges respectively (p < 0.001).
CONCLUSIONS: There is no significant relationship between hypotension and use of LA during GA, obese children are at a higher risk of O2S < 90% during OCS, and patients receiving Articaine experience less post-treatment excessive pain than those receiving lidocaine during GA.