The use of laryngeal mask airway in dental treatment during sevoflurane deep sedation

Background General anesthesia is frequently considered for pediatric patients, as they often find it difficult to cooperate and stay calm during administration of potentially painful treatments. Sedation can overcome these adversities; however, this is challenging while maintaining unobstructed airways. Methods The study involved 11 pediatric dental patients treated with LMA under deep sedation with sevoflurane, from 2011 through 2015. LMA size, sevoflurane concentration, and the vital signs of patients were assessed through a chart review. Results The age distribution of the patients ranged from 6 to 10 years old. A total of 3 patients underwent mesiodens extraction, while the remaining 8 underwent an surgically assisted orthodontic forced tooth eruption The average sedation period was approximately 45 minutes and the LMA size was 2½. The sevoflurane concentration was maintained at 2% on average, and overall, the measurements of vital signs were within the normal range; the patients had an average blood pressure of 98/49 mmHg, breathing rate of 26 times/min, pulse frequency of 95 times/min, SpO2s level of 99 mmHg, and ETCO2 level of 41.2 mmHg. Conclusions Deep sedation with sevoflurane coupled with LMA may be applied successfully in pediatric patients who undergo mesiodens extraction or a surgically assisted orthodontic forced tooth eruption.

[1]  O. Beirne,et al.  Laryngeal mask airways have a lower risk of airway complications compared with endotracheal intubation: a systematic review. , 2010, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[2]  R. Terrell The invention and development of enflurane, isoflurane, sevoflurane, and desflurane. , 2008, Anesthesiology.

[3]  M. Troop The use of the laryngeal mask airway with mechanical positive pressure ventilation. , 2005, AANA journal.

[4]  N. Gordon,et al.  Sevoflurane general anesthesia: an alternative technique in the pediatric oral and maxillofacial surgery patient. , 2003, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[5]  P. Averley,et al.  Comparison of sevoflurane and nitrous oxide mixture with nitrous oxide alone for inhalation conscious sedation in children having dental treatment: a randomised controlled trial , 2002, Anaesthesia.

[6]  I. Kageyama,et al.  The relationship of placement accuracy and insertion times for the laryngeal mask airway to the training of inexperienced dental students. , 2002, Anesthesia progress.

[7]  P. Averley,et al.  Sevoflurane inhalation conscious sedation for children having dental treatment , 2001, Anaesthesia.

[8]  P. Yate,et al.  Comparison of sevoflurane and halothane for outpatient dental anaesthesia in children. , 1997, British journal of anaesthesia.

[9]  S. Zandsberg,et al.  Use of the laryngeal mask airway in oral and maxillofacial surgery. , 1996, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[10]  J. Brimacombe,et al.  The laryngeal mask airway for dental surgery--a review. , 1995, Australian dental journal.

[11]  A. Goodwin The reinforced laryngeal mask in dental day surgery , 1993 .

[12]  I. Stern,et al.  Sevoflurane: A New Inhalational Anesthetic Agent , 1975, Anesthesia and analgesia.