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Article Contents

  • Objective
  • Methods
  • Results
  • Conclusion
  • METHODS AND MATERIALS
  • Statistical Analysis
  • RESULTS
  • DISCUSSION
  • CONCLUSION
  • ACKNOWLEDGMENTS
  • REFERENCES
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Objective

The risk of a spontaneous surgical fire increases as oxygen concentrations surrounding the surgical site rise above the normal atmospheric level of 21%. Previously published in vitro findings imply this phenomenon (termed oxygen pooling) occurs during dental procedures under sedation and general anesthesia; however, it has not been clinically documented.

Methods

Thirty-one children classified as American Society of Anesthesiologists I and II between 2 and 6 years of age undergoing office-based general anesthesia for complete dental rehabilitation were monitored for intraoral ambient oxygen concentration, end-tidal CO2, and respiratory rate changes immediately following nasotracheal intubation or insertion of nasopharyngeal airways, followed by high-speed suctioning of the oral cavity during simulated dental treatment.

Results

Mean ambient intraoral oxygen concentrations ranging from 46.9% to 72.1%, levels consistent with oxygen pooling, occurred in the nasopharyngeal airway group prior to the introduction of high-speed oral suctioning. However, 1 minute of suctioning reversed the oxygen pooling to 31.2%. Oropharyngeal ambient oxygen concentrations in patients with uncuffed endotracheal tubes ranged from 24.1% to 26.6% prior to high-speed suctioning, which reversed the pooling to 21.1% after 1 minute.

Conclusion

This study demonstrated significant oxygen pooling with nasopharyngeal airway use before and after high-speed suctioning. Uncuffed endotracheal intubation showed minimal pooling, which was reversed to room air ambient oxygen concentrations after 1 minute of suctioning.

Keywords: Pediatric dentistry; Office-based general anesthesia; Oxygen pooling; Surgical fires; Operative dentistry
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Copyright: © 2023 by the American Dental Society of Anesthesiology
Citations

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 Hiroshi Kawahara DDS, PhD

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Article Contents

Comparison of Remimazolam and Propofol for Intubated General Anesthesia for Oral and Maxillofacial Surgery

Yoshio Hayakawa DDS, PhD,
 Keiko Fujii-Abe DDS, PhD,
 Sayaka Akitomi DDS,
 Shihomi Niwa DDS,
 Michiru Abe DDS,
 Manami Otsuka DDS, PhD,
 Maho Ikeda DDS,
 Takumi Ishikawa DDS, PhD,
 Manami Yajima DDS, PhD, and
 Hiroshi Kawahara DDS, PhD

The Impact of COVID-19 on Dental Anesthesiologists: An Online Survey of Board-Certified Dental Anesthesiology Specialists of the Japanese Dental Society of Anesthesiology

Takuro Sanuki DDS, PhD,
 Hidetaka Kuroda DDS, PhD,
 Uno Imaizumi DDS, PhD,
 Shota Tsukimoto DDS, PhD,
 Norika Katagiri DDS, PhD,
 Ayako Mizutani DDS, PhD,
 Mari Ohnaka DDS,
 Shinji Kurata DDS, PhD,
 Naotaka Kishimoto DDS, PhD, and
 Kanta Kido DDS, PhD

Tracheal Bronchus Detected During General Anesthesia: A Case Report

Toru Yamamoto DDS, PhD,
 Tatsuru Tsurumaki DDS, PhD,
 Hiroko Kanemaru DDS, PhD, and
 Kenji Seo DDS, PhD

Management of an Ingested Foreign Body in a COVID-Positive Patient

Tiffany Smith BS,
 Rachel Blum BS, and
 Raquel Rozdolski DMD
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