An evaluation of perioperative respiratory complications and adjournment of operation in pediatric ambulatory anesthesia for dental procedures

Ambulatory anesthesia is often performed for children who are not obedient for dental treatment. We investigated the backgrounds of cases that were adjourned, and the occurrence of respiratory complications during general anesthesia in cases that were adjourned because of common cold. The subjects were 427 pediatric cases scheduled for ambulatory anesthesia at the Department of Dental Anesthesia in Kyushu University Hospital from January 2008 to May 2012. The study was performed by retrospectively extracting information from anesthesia records. In 308 cases out of 427, general anesthesia was performed as scheduled. Six cases were cancelled as general anesthesia became unnecessary and 54 cases were adjourned due to bad general condition showing symptoms of common cold. We compared the age and seasons between the 308 cases treated as scheduled (conducted group) and 51 cases adjourned because of bad condition (adjournment group). The ages were divided into four stages, 1-2, 3-5, 6-8 and 9-15 years old. The seasons were also divided into four (spring, summer, autumn, winter) at the time of scheduled date. The rate of adjournment at the stage of 1-2 years old was significantly higher than those at other stages. There was no significant difference in the rate of adjournment between the seasons. We investigated the occurrence of respiratory complications in the adjournment group during general anesthesia. The duration of adjournment was significantly shorter in the cases with perioperative respiratory complications. These results suggest that pediatric patients tend to fall sick easily regardless of their primary disease, especially at younger ages. In addition, it is important to allow a sufficient period of adjournment to reduce the occurrence of respiratory complications. The conditions of pediatric patients may change very easily during the perioperative period, therefore it is important to contact parents appropriately. It is also important to pay attention to the conditions of pediatric patients to avoid respiratory complications and perform ambulatory anesthesia safely.