ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Children With Obstructive Sleep Apnea Receiving Dental Procedures Under General Anesthesia are at Increase Risk For Respiratory Complications During Recovery?
Clinical Question For children with history of obstructive sleep apnea undergoing dental rehabilitation under general anesthesia, as compared to the general population, would they have an increase risk of complications during recovery?
Clinical Bottom Line Evidence shows that children with history of obstructive sleep apnea (1-3% of children) should be evaluated and followed up closely since they are at higher risk for respiratory complications after general anesthesia.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 19535696Schwengel/2009Lit review- 195 articles, no meta- analysisReview
Key resultsPatients with obstructive sleep apnea (1-3% of children) have a higher perioperative anesthesia risk and may require admission or longer observation periods before discharge. Risk factors to OSA in children are obesity, enlarged adenoids/tonsils, craniofacial abnormalities and some congenital syndromes.
#2) 17056942Sanders/200682 children 2-16 y.o.: 62 w/OSA compared to 21 without OSA following adenotonsillectomyCohort
Key resultsPatients with OSA are at higher risk of perioperative respiratory complications after adenotonsillectomy when compared to a non OSA sample
Evidence Search (obstructive sleep apnea) AND anesthesia complications AND ("last 10 years"[PDat] AND (infant[MeSH] OR child[MeSH] OR adolescent[MeSH])) 2nd search: ("sleep apnea, obstructive"[MeSH Major Topic] AND "postoperative complications"[MeSH Major Topic]) AND ("child"[MeSH Terms] OR "child"[All Fields] OR "children"[All Fields])
Comments on
The Evidence
Validity: No study was found that would address anesthesia complications in the OSA population following dental rehabilitation. In the article by Sanders the study groups showed similar characteristics, all completed the study, all procedures were performed by the same surgeon and same anesthesia protocol was used, observers were blinded. The Schwengel review article presents a comprehensive detailed summary of available information but did not assess the individual studies for validity and no meta- analysis was performed.
Applicability This is applicable to health care providers treating children with special needs and/ or extensive dental needs that require treatment under general anesthesia.
Specialty/Discipline (General Dentistry) (Oral Surgery) (Pediatric Dentistry)
Keywords Obstructive sleep apnea, dental rehabilitation, pediatric, behavior management, special needs patient
ID# 2348
Date of submission: 03/04/2013spacer
E-mail cervantesmen@uthscsa.edu
Author Maria Jose Cervantes Mendez, DDS
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Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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