Study, ASA Recommend Children's Procedures be Combined to Limit Anesthesia Exposure

In light of the recent American Dental Association (ADA) adoption of new anesthesia and sedation guidelines for dental practitioners, the American Society of Anesthesiologists (ASA) has reviewed new research presented at their 2016 annual meeting. Based on the new research, the ASA now recommends that children having both dental and non-dental medical procedures should have them completed in one session whenever possible, so that they are exposed to general anesthesia only once.

The research presented at the annual meeting implies that this type of arrangement is ideal to the patient and their family. Millions of children each year require surgery for dental and non-dental medical conditions, and some of these children need to be placed under general anesthesia in order for the work to be completed. In dentistry, some children require sedation with general anesthesia for procedures such as teeth extraction or capping.

The study examined 55 children who had a dental procedure performed along with another non-dental medical procedure at the same time while exposed to only one general anesthesia medication. According to the research, 87% of the children did not experience any complications from combining procedure types under one anesthesia exposure. Seven of the children, 13%, experienced side effects like vomiting, pain, fever, and pneumonia. Out of this 13%, 4 children, or 7%, required unplanned admission to a hospital.

Additionally, the research found that combining dental and non-dental medical procedures in one anesthesia session lead to a cost savings of approximately $165,000 for 60 sample patients.

When possible, dental procedures requiring the use of general anesthesia should be performed alongside other medical procedures requiring the same level of sedation, like tonsil removal or insertion of ear tubes. Dental work could even be performed along with diagnostic tests like magnetic resonance imaging (MRI), which requires that children be sedated to prevent any movement.

The lead author of the study, Vidya T. Raman, MD, noted that “while surgery and anesthesia are safer than they’ve ever been, limiting exposure is preferable, especially in children, because there may be sensitivities or a greater risk of anesthesia-related complications. In addition to improving patient safety, we believe combining procedures decreases costs and improves patient satisfaction.”