title: Oral rehabilitation under dental general anesthesia, conscious sedation, and conventional techniques in patients affected by cerebral palsy.
abstract: The purpose of this report is to find the use of different alternatives for dental treatment, from general anesthesia to conventional techniques, in patients affected by cerebral palsy (CP) in a dental school setting. The sample was divided into two groups: (1) children, and (2) adolescents and young adults; 38 patients (20 female and 18 male) with diagnostic of CP were included. Risks and benefits of conscious sedation and general anesthesia were written into a consent form and these were discussed with parents or guardians of each affected patient. The mean age was 7.14+/-2.2 years for children's group and 18.5+/-3.06 years for adolescent and young adult group. Most children (77.3%) were classified as ASA II with a level of behavior I-II according to Frankl's scale and these patients were treated under general anesthesia (GA). For patients that were classified as of positive behavior with little necessity of dental procedures, independent of the medically compromised level, dental treatment was done with conventional techniques or with conscious sedation. Dental frequency procedures were as follows: composites, dental prophylaxis, and dental extractions in children; in adolescents and adults, important to point out is that in anterior teeth and molars endodontic treatment, and surgical procedures increased in frequency. The mixture sevoflurane-propofol worked well during pre-, peri-, and post-operative procedures. During the discharge process, most patients needed a recovery of 20-40 minutes after which they were awake and oriented, breathing comfortably with stable vital signs. It was concluded that GA with sevoflurane-propofol and conscious sedation are an excellent tool to provide dental treatment in CP patients in a dental school setting without most of the major postoperative complications, such as nausea and vomiting.
authors.affiliation: Dental Research Center, San Luis Potosi University, Mexico. jloyola@uaslp.mx
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Loyola-Rodriguez
authors.forename: Ana Alicia
authors.initials: AA
authors.lastname: Aguilera-Morelos
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Santos-Diaz
authors.forename: Veronica
authors.initials: V
authors.lastname: Zavala-Alonso
authors.forename: Claudia
authors.initials: C
authors.lastname: Davila-Perez
authors.forename: Honorio
authors.initials: H
authors.lastname: Olvera-Delgado
authors.forename: Nuria
authors.initials: N
authors.lastname: Patiño-Marin
authors.forename: Iris
authors.initials: I
authors.lastname: De Leon-Cobian
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D000762:Anesthesia Recovery Period; D000766:Anesthesia, Dental; D000768:Anesthesia, General; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D002547:Cerebral Palsy / Q000523:psychology; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D016292:Procedural Sedation; D003299:Cooperative Behavior; D003730:Dental Care for Persons with Disabilities; D003814:Dentistry, Operative; D005260:Female; D006801:Humans; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage; D015742:Propofol / Q000008:administration & dosage; D018570:Risk Assessment; D000077149:Sevoflurane
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D015742:Propofol