title: COMPLICATIONS OF ORAL AND MAXILLOFACIAL SURGERY UNDER GENERAL ANESTHESIA IN TUBE-FED CHILDREN: A RETROSPECTIVE ANALYSIS.
abstract: OBJECTIVE
  To assess morbidity and mortality associated with oral and maxillofacial surgery procedures requiring general anesthesia among children with aspiration tendency requiring enteral feeding.
  
  
  METHODS
  A retrospective chart review was conducted of children surgically treated under general anesthesia by the oral and maxillofacial surgery service at the Hospital for Sick Children in Toronto, Canada. Medical and dental records over a 9-year period (January 1, 2000 to January 1, 2010) were reviewed. Data were collected on demographics, primary illness, coexisting medical conditions, procedures performed, medications administered, type of airway management used, duration of general anesthesia, American Society of Anesthesiologists' physical status classification and adverse events.
  
  
  RESULTS
  During the period reviewed, 28 children underwent 35 oral and maxillofacial surgery procedures under general anesthesia. The mean patient age was 12 years (range 4-17 years). No deaths occurred. Of the 35 surgeries, 10 (29%) were associated with at least 1adverse event. Adverse events included 1incident of respiratory distress, 2incidents of fever, 5incidents of bleeding, 1incident of seizure and 4incidents of oxygen saturation below 90% for more than 30s.
  
  
  CONCLUSIONS
  Children with a history of aspiration tendency that necessitates enteral feeding, who undergo oral and maxillofacial surgery under general anesthesia, are at increased risk of morbidity. Before initiating treatment, the surgeon and parents or guardians of such children should carefully consider these risks compared with the anticipated benefit of surgery.
authors.affiliation: The Hospital for Sick Children, Toronto ON.
authors.forename: Trang D
authors.initials: TD
authors.lastname: Nguyen
authors.forename: Marshall M
authors.initials: MM
authors.lastname: Freilich
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Macpherson
mesh_terms: D000293:Adolescent; D000768:Anesthesia, General; D002170:Canada; D002648:Child; D002675:Child, Preschool; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D008297:Male; D056948:Orthognathic Surgical Procedures / Q000009:adverse effects*; D012189:Retrospective Studies; D013515:Surgery, Oral