8 General anaesthesia

8

General Anaesthesia

Indications for General Anaesthesia

General anaesthesia (GA) carries risks of morbidity and mortality. It should only be considered when treatment using local analgesia or a combination of local analgesia and sedation has failed or is inappropriate. Factors to consider before choosing GA are: the ability of the child to cooperate, the child’s degree of anxiety, anticipated surgical trauma, complexity of the procedure (e.g. extractions in multiple quadrants, severe dento-alveolar trauma), presence of acute dental infection, past dental history and medical history of the child (Table 8.1).

Table 8.1 Medical conditions requiring consideration when planning treatment under GA.

Medical condition Examples
Cardiac Congenital heart disease, cardiomyopathies and dysrhythmias
Respiratory Asthma, croup, cystic fibrosis
Haematological Haemophilia, Von Willebrands, thrombocytopenia, aplastic anaemia, haemoglobinopathies
Immunocompromised Primary (e.g. asplenia) and acquired (e.g. HIV, chemotherapy)
Endocrine Diabetes, hypothyroid, hyperthyroid
Metabolic Malignant hyperthermia, suxamethonium sensitivity
Gastrointestinal Reflux, difficulty swallowing or feeding
Neurological Epilepsy, cerebral palsy
Renal Renal failure, nephrotic syndrome
Liver Hepatitis, biliary atresia, alpha-1 antitrypsin deficiency
Neuromuscular Muscular dystrophy
Syndromes Down, DiGeorge, Williams
Difficult airways Pierre Robin, sleep apnoea, obesity, cleft palate, micrognathia
Allergies Latex, penicillin, elastoplast, EMLA, Ametop

Planning Treatment under GA

Treatment should be planned with the aim of ensuring all treatment is provided unde/>

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Jan 17, 2015 | Posted by in Pedodontics | Comments Off on 8 General anaesthesia
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