Abstract
Background: Uncooperative children require sedative approach for dental treatment. The aim was to assess the effectiveness of Propofol in “Non-Operating Room Anesthesia” (NORA) for paediatric dental treatment; intraoperative side effects; postoperative side effects; post-discharge effects. Methods: a prospective study, involving 109 uncooperative children undergoing sedation in NORA using Propofol for dental treatment, was performed. Working sessions, success/failure, intraoperative and postoperative side effects, number of treatment; type of procedure were assessed. Parents completed a post-discharge questionnaire on: pain; crying; fever; vomiting; headache; drowsiness; excitability; irritability; ability to eat; drugs and medical care needing. Results: Success: 96.7%. Intraoperative side effects: 33.3%. Postoperative side effects: 6.4%. Statistically significant association between: intraoperative side effects and age (p = 0.001), health status (p = 0.0007), weight (p = 0.038), respectively; intraoperative side effects and number/ type of dental treatment (p = 0.0055) and scaling (p = 0.0001), respectively. For post-discharge questionnaires, statistically significant association between: age and crying (p = 0.0001) and headache (p = 0.002), respectively; health status and crying (p = 0.015) and drugs needing (p = 0.04), respectively; weight and crying (p = 0.0004); extraction and pain (p = 0.0001) and crying (p= 0.0073), respectively; scaling and crying (p = 0.04), excitability and irritability (p = 0.03), respectively. Conclusion: Propofol in NORA was effective with minimal side effects.
Highlights
Uncooperative children behavior makes dental treatment difficult and prejudices the quality of treatment provided; this causes a worsening of oral health with a higher incidence of untreated caries and more caries for uncooperative paediatric patients than their less anxious and more cooperative peers [1,2]
This prospective study used a convenience sample of uncooperative children which includes all consecutive patients referred for intravenous sedation in NORA with Propofol for dental treatment at the Dental Clinic of the University Hospital of Naples “Federico II”, Naples, Italy
This study demonstrated that intravenous sedation with Propofol in NORA can be used successfully when the dental treatment is essential, and the child does not cooperate during treatment
Summary
Uncooperative children behavior makes dental treatment difficult and prejudices the quality of treatment provided; this causes a worsening of oral health with a higher incidence of untreated caries and more caries for uncooperative paediatric patients than their less anxious and more cooperative peers [1,2]. Even though behavioral techniques could be useful to obtain children cooperation, some paediatric patients do not permit dental treatment and may require sedative approach [5,6]. The aim was to assess the effectiveness of Propofol in “Non-Operating Room Anesthesia” (NORA) for paediatric dental treatment; intraoperative side effects; postoperative side effects; post-discharge effects. Success/failure, intraoperative and postoperative side effects, number of treatment; type of procedure were assessed. For post-discharge questionnaires, statistically significant association between: age and crying (p = 0.0001) and headache (p = 0.002), respectively; health status and crying (p = 0.015) and drugs needing (p = 0.04), respectively; weight and crying (p = 0.0004); extraction and pain (p = 0.0001) and crying (p= 0.0073), respectively; scaling and crying (p = 0.04), excitability and irritability (p = 0.03), respectively. Conclusion: Propofol in NORA was effective with minimal side effects
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