title: The effect of local anesthetic on quality of recovery characteristics following dental rehabilitation under general anesthesia in children.
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.
authors.affiliation: LSU School of Dentistry, Department of Pediatric Dentistry, New Orleans, Louisiana 70119, USA. jtown2@lsuhsc.edu
authors.forename: Janice A
authors.initials: JA
authors.lastname: Townsend
authors.forename: Steven
authors.initials: S
authors.lastname: Ganzberg
authors.forename: S
authors.initials: S
authors.lastname: Thikkurissy
mesh_terms: D000762:Anesthesia Recovery Period; D000766:Anesthesia, Dental; D000768:Anesthesia, General; D000779:Anesthetics, Local / Q000008:administration & dosage*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use; D001734:Bites, Human / Q000209:etiology; D002610:Cheek / Q000293:injuries; D002652:Child Behavior; D002675:Child, Preschool; D003442:Crowns; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007275:Injections, Intravenous; D020911:Ketorolac Tromethamine / Q000008:administration & dosage / Q000627:therapeutic use; D008012:Lidocaine / Q000008:administration & dosage*; D008046:Lip / Q000293:injuries; D008297:Male; D009061:Mouth Mucosa / Q000293:injuries; D009065:Mouth Rehabilitation; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control; D011183:Postoperative Complications; D011446:Prospective Studies; D011670:Pulpectomy; D011672:Pulpotomy; D014081:Tooth Extraction
chemical_list: D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D020911:Ketorolac Tromethamine; D008012:Lidocaine