Clinical study on hemodynamics and analgesic effect of local infiltration anesthesia in the treatment of severe early childhood caries under general anesthesia

doi:10.7518/hxkq.2025.2025223

Abstract

Abstract:

Objective This study aimed to explore the clinical efficacy of severe early childhood caries (SECC) treatment combined with local anesthesia under general anesthesia. Methods A total of 108 children under 6 years old who underwent SECC dental treatment under general anesthesia at the Department of Pediatric Dentistry, Third Affiliated Hospital of Air Force Medical University from March to December 2023 were selected as the study subjects, with American Society of Anesthesiologists (ASA) classification of classⅠor Ⅱ. The study subjects were divided into a control group (n=54) and an experimental group (n=54) by retrieving intraoperative cases and postoperative follow-up records. The control group was given general anesthesia through inhalation combined with nasotracheal intubation, whereas the experimental group was given local anesthesia with 2% lidocaine on each treated tooth on the basis of general anesthesia. The basic information, preoperative anesthesia depth, hemodynamic changes during different surgical procedures, postoperative pain, and adverse reactions in the two groups were recorded and analyzed. Results No statistically significant difference was found in the basic information and preoperative anesthesia depth between the two groups (P>0.05). Among the three procedures (pulpotomy, root canal treatment, and tooth extraction), the three observed indicators in the experimental group were significantly lower than those in the control group (P<0.05). The proportion of patients in the experimental group who needed to take analgesic measures in accordance with the modified facial pain scale (FPS-R) score was significantly lower than that in the control group at postoperative wakefulness and 2 h after surgery (P<0.05). Meanwhile, no statistically significant difference was observed between the groups at 24 h after surgery (P>0.05). The proportion of patients in the experimental group who needed to take analgesic measures on the basis of the parent posto-perative pain measurement (PPPM) score was significantly lower than that in the control group when they were awake after surgery (P<0.05). No statistically significant difference was found between the groups at 2 and 24 h after surgery (P>0.05). Moreover, no statistically significant difference was observed in the incidence of adverse reactions between the two groups at 24 h after surgery (P>0.05). Conclusion The combination of local anesthesia during SECC dental treatment under general anesthesia results in minimal changes in intraoperative hemodynamics and mild postoperative pain response, hence worthy of clinical promotion.

Key words: severe early childhood caries, general anesthesia, local anesthesia, pain management, hemodynamics

CLC Number:

R788

Lu Xiaoxi, Yang Kuan, Zhang Baize, Zhang Yaqiu, Wang Junhui, Han Xinxin, Chen Yujiang, Wang Xiaojing. Clinical study on hemodynamics and analgesic effect of local infiltration anesthesia in the treatment of severe early childhood caries under general anesthesia[J]. West China Journal of Stomatology, 2025, 43(4): 493-498.

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References 32

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项目	对照组（n=54）	实验组（n=54）	χ²/t值	P值
男∶女	29∶25	26∶28	0.334	0.561
年龄/月	58.23±8.42	56.94±9.56	0.105	0.725
身高/cm	109.05±9.37	106.14±10.18	0.524	0.697
体重/kg	18.11±4.09	17.26±3.87	1.705	0.568
治疗牙数/颗	13.62±3.18	14.53±2.83	2.723	0.354
术前PSI	42.34±5.48	44.89±5.24	3.976	0.128
丙泊酚/mg	37.26±5.27	36.43±5.04	0.168	0.746
芬太尼/μg	36.50±4.37	35.96±4.76	0.089	0.839
顺式阿曲库铵/mg	1.79±0.33	1.71±0.26	1.347	0.625
地塞米松/mg	3.61±0.59	3.42±0.49	2.145	0.427

项目	对照组（n=54）	实验组（n=54）	t值	P值
间接牙髓治疗术
心率变化/（次/min）	1.26±0.81	1.04±0.75	1.038	0.304
收缩压变化/mmHg	0.89±0.75	0.70±0.77	0.891	0.377
舒张压变化/mmHg	0.59±0.63	0.48±0.58	0.671	0.505
牙髓切断术
心率变化/（次/min）	5.44±1.08	4.52±1.18	2.988	0.004
收缩压变化/mmHg	2.74±0.98	2.11±0.80	2.579	0.013
舒张压变化/mmHg	2.04±0.85	1.37±0.92	2.750	0.008
根管治疗术
心率变化/（次/min）	4.78±1.31	4.04±1.28	2.097	0.041
收缩压变化/mmHg	2.59±1.01	1.81±0.92	2.956	0.005
舒张压变化/mmHg	2.22±1.12	1.56±1.05	2.255	0.028
牙拔除术
心率变化/（次/min）	6.04±1.42	4.89±1.25	3.144	0.003
收缩压变化/mmHg	3.52±0.89	2.78±1.08	2.737	0.008
舒张压变化/mmHg	2.56±1.18	1.89±0.93	2.293	0.026

项目	对照组（n=54）	实验组（n=54）	χ²值	P值
FPS-R
术后清醒时	24（44.44%）	14（25.93%）	4.060	0.044
术后2 h	19（35.19%）	9（16.67%）	4.821	0.028
术后24 h	10（18.52%）	6（11.11%）	1.174	0.279
PPPM
术后清醒时	22（40.74%）	11（20.37%）	5.280	0.022
术后2 h	15（27.78%）	8（14.81%）	2.707	0.100
术后24 h	9（16.67%）	4（7.41%）	2.186	0.139
术后24 h不良反应	25（46.30%）	20（37.04%）	0.952	0.329