Editorial Type:
Article Category: Research Article
 | 
Online Publication Date: 01 Jan 2009

The Effect of Local Anesthetic on Quality of Recovery Characteristics Following Dental Rehabilitation Under General Anesthesia in Children

DDS, MS,
DMD, MS, and
DDS, MS
Page Range: 115 – 122
DOI: 10.2344/0003-3006-56.4.115
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Abstract

This study is a randomized, prospective, double-blind study to evaluate the effects of the combination of local anesthetics and an intravenous nonsteroidal anti-inflammatory drug (NSAID) vs NSAID alone on quality of recovery following dental rehabilitation under general anesthesia (GA). Twenty-seven healthy children aged 3–5.5 years underwent dental rehabilitation under GA. Fifteen children in the experimental group received oral infiltration of local anesthetic in addition to intravenous ketorolac tromethamine, while 12 children in the control group received intravenous ketorolac tromethamine alone for postoperative pain management. Pain behaviors were evaluated immediately postoperatively using a FLACC scale and 4 hours postoperatively by self-report using various scales. Parents reported perception of child pain and comfort and any occurrences of postoperative cheek biting. The use of intraoral infiltration local anesthesia for complete dental rehabilitation under general anesthesia for children aged 3–5.5 years did not result in improved pain behaviors in the postanesthesia care unit (PACU), nor did it result in improved pain behaviors 4–6 hours postoperatively as measured by the FLACC scale, FACES scale, and subjective reports of parents or a PACU nurse. Those children receiving local anesthesia had a higher incidence of negative symptoms related to local anesthetic administration, including a higher incidence of lip and cheek biting, which was of clinical importance, but not statistically significant. Infiltration of local anesthetic for dental rehabilitation under general anesthesia did not improve quality of recovery in children aged 3–5.5 years.

Copyright: 2009 by the American Dental Society of Anesthesiology
Figure 1
Figure 1

FLACC scale.14


Figure 2
Figure 2

Wong-Baker FACES scale.16


Figure 3
Figure 3

Postoperative phone call FACES scores.


Figure 4
Figure 4

Postoperative phone call VAS scores.


Figure 5
Figure 5

Tissue damage postoperatively reported by parents.


Figure 6
Figure 6

Negative symptoms postoperatively reported by parents.


Contributor Notes

Address correspondence to Dr Janice A. Townsend, Assistant Professor, LSU School of Dentistry, Department of Pediatric Dentistry, 1100 Florida Ave, New Orleans, LA 70119; jtown2@lsuhsc.edu.
Received: 03 Jun 2008
Accepted: 06 Nov 2008
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