儿童全身麻醉下牙齿治疗术后反应的调查分析

Postoperative complications following dental rehabilitation under general anesthesia in children

目的 通过调查问卷统计全身麻醉（简称全麻）下儿童牙齿治疗术后反应的种类和发生率,分析术后疼痛的影响因素.方法 收集124例2至8周岁全身健康儿童在日间门诊进行全麻下牙齿治疗的资料,包括儿童口腔科医师和麻醉医师提供的儿童一般情况和治疗信息以及术后家长填写的术后反应问卷信息.术后反应问卷包含术后1周内儿童牙齿疼痛、发热、用药以及与全麻相关的不适症状.应用牙齿疼痛问卷（dental discomfort questionnaire-8,DDQ-8）评估牙齿疼痛程度.结果 全麻下牙齿治疗手术平均时长为102.6 min,平均每例儿童治疗牙数为13.5颗.66.9%（83/124）的患者术后第1天有不适反应.术后最常见的反应依次为咳嗽、声音嘶哑、牙齿疼痛、咽喉疼痛、不愿进食、肿胀、虚弱、嗜睡、呕吐、发热及恶心.这些术后反应随时间推移逐渐好转,至术后第7天仅存牙齿疼痛及咳嗽.术前DDQ-8分值以及拔牙数量与术后第1天的牙齿疼痛显著相关.结论 牙齿疼痛和咽部不适是全麻下牙齿治疗最常见的术后反应;术后第1天牙齿疼痛与术前牙疼及拔牙数量有关.

Objective To assess the postoperative complications in systemically healthy children treated for dental caries under general anesthesia （GA） after discharge and analysis of the correlative factors. Methods This prospective observational study included 124 children aged 2-8 years old who received extensive dental treatment under GA. General conditions and treatment information were obtained from questionnaires filled by the dentist and the anesthesiologist. Postoperative data were collected from a questionnaire filled by the parents in one week. Pain was assessed by using the dental discomfort questionnaire-8 （DDQ-8） pain assessment scale. Results The mean anesthesia time for GA procedures was 102.6 min and the mean number of treated teeth was 13.5. Approximately 66.9%（83/124） of the children had one or more postoperative complaints on the first day after the treatments. The most common complaints reported were cough, hoarseness, and dental pain followed by throat discomfort, problems in eating, swelling, weakness, sleepiness, vomiting, fever and nausea. By the seventh day after the treatment, the main complications remained were dental pain and cough, while most of other symptoms disappeared. Preoperative DDQ-8 score and the number of extracted teeth were the factors that showed a significant association with postoperative dental pain on the first day. Conclusions Dental pain and pharynx discomfort were most frequently noted postoperative symptoms. Postoperative dental discomfort on the first day might be predicted by dental pain before GA and tooth extraction under GA.