Assessment of the oxygen status of the brain during the oral cavity sanation in children aged 3–7 years under general anesthesia on an outpatient setting

  • O. I. Koval O. Bohomolets National Medical University
Keywords: cerebral oximetry, SpO2, rSO2, general anesthesia


Summary. Unfortunately, today, mental and behavioral disorders in children are quite common. It is proved that one of the main causes of cognitive decline is the disease of the small vessels of the brain. In the literature, there are data on the study of the relationship of cognitive impairment due to functional changes on the background of oxygen starvation of the brain.

The aim of the study – the article presents the rationale for the need to limit the time for oral rehabilitation in an outpatient setting under general anesthesia in order to preserve the cognitive functions of the brain of the child due to its functional changes in violation of the oxygen status of cerebral vessels.

Materials and Methods. The oral cavity sanation in the conditions of general anesthesia was conducted in 39 children aged 3–7 years on the basis of the Dental Medical Center at the National Medical University named after O. O. Bohomolets. This age group of children according to the classification of temperament (Thomas and Chess, 1997) includes: 11 children with “mild” temperament; 19 children – with «difficult» temperament; 9 children – temperament «long warms up». In order to monitor the oxygen status of the brain, cerebral oximetry was used.

Results and Discussion. The linear decrease of rSO2 occurs from 43 minutes. To 60 min. rSO2 = (58.6±0.01) %, with a possible minimum value of 60.26 %. Min rSO2 within the normal range = (60.26±0.22) % is between 57 and 58 minutes. Therefore, in order to prevent the occurrence of brain hypoxia, dental rehabilitation of the oral cavity for children aged 3–7 years should be performed within (40±15) min. Respiratory complications (laryngospasm) in 10.25 % of children were noted during the rehabilitation of the oral cavity under general anesthesia. The mean rSO2 for laryngospasm is (68.83±7.39) %, which is 8.63 % relative to the mean rSO2 of the respective age group (rSO2 = (75.33±2.68) %). SO rSO2 of 16 min. 33 minutes each (≤20 min) by 11.42 % (rSO2 = (60.57±5.44) %). The peak of the decline occurred in 20–21 min. (rSO2 = (53.5±2.45 %) and accounted for 28.97 % of the total group value and 11.67 % of rSO2 directly for laryngospasm. In 75 % of children who had complications in the form of laryngospasm during the rehabilitation of the oral cavity under general anesthesia were noted ≤ 2 weeks after complete recovery for acute respiratory diseases (ARD). In order to study the effect of inflammatory processes of the respiratory tract on the possibility of complications in the process of dental rehabilitation in the outpatient setting under general anesthesia, we selected a group of children who had a history of ≥2 weeks but ≤ 4 weeks (group I) and analyzed the results indices of rSO2 with a group of children who had a history of ARD with a history of ≤ 2 weeks (group II) relative to those of rSO2 in the general group of children aged 3–7 years (group III). rSO2 in children of group I – (68.65±7.72) % ↓ rSO2 from 16 min to 32 minutes (≤20 min) is 14.59 % (rSO2 = (58.63±4.55) %). In the group II of children, rSO2 (74.92±6.84) %) coincides with rSO2 (74.84±6.63) %) in group III.

Conclusions. Dental sanitation of the oral cavity under general anesthesia on an outpatient basis for children aged 3–7 years has a time limit (40±15) min. A contraindication for routine oral sanitation under general anesthesia on an outpatient basis is the presence of acute respiratory infections in the history of ≤ 2 weeks. In acute dental conditions, if there is a history of acute respiratory infections ≤ 2 weeks, ambulance care on an outpatient basis under general anesthesia is possible within 15 minutes. SpO2 values do not correlate with rSO2 indicators. The method of cerebral oximetry makes it possible to early detect changes in the oxygen balance of the brain and support it in time. The method of cerebral oximetry makes it possible to early detect changes in the oxygen balance of the brain and support it in time.


Akselrod, B.A. (2012). Monitoring tkanevoy oksigenatsii: novaya volna v palitre anesteziologa [Monitoring tissue oxygenation: a new wave in the palette of the anesthetist]. Vestnik intensivnoy terapii – Intensive Care Unit, 1, 8-14 [in Russian].

Davydova, N.S. (2004). Vozmozhnyye kriterii prognoza narusheniy mozgovogo krovoobrashcheniya pri anestezii [Possible criteria for the prediction of cerebrovascular accidents during anesthesia]. Vestnik intensivnoy terapii – Intensive Care Unit, 5, 232-234 [in Russian].

Knyazev, A.V. (2006). Tserebralnyye i metabolicheskiye narusheniya pri operativnykh vmeshatelstvakh pod obshchim obezbolivaniyem u detey [Cerebral and metabolic disorders during surgical interventions under general anesthesia in children]. Candidate’s Extended abstract. Moscow: Regional Research Clinical Institute by M.F. Vladimirskiy. [in Russian].

Kuznetsov, V.M., Prohno, O.I., Koval, P.B., & Kosenko, O.M. (2015). Spivpratsia “dytyna-stomatolohbatky” ‒ zaporuka uspishnoho likuvannia [Cooperation “child-dentist-parents” ‒ guarantee successful treatment]. Neonatolohiia, khirurhiia ta perynatalna medytsyna – Neonatology Surgery and Perinatal Medicine, 4 (18), 19-26 [in Ukrainian].

Lubin, A.U., & Shmigelaky, A.V. (1996). [Cerebral oximetry]. Anesteziya i reanimatologiya – Anesthesia and resuscitation, 2, 85-90 [in Russian]. 6. Lobov, M.A., & Dreval, A.A. (2013). Vliyaniye propofola na gippokamp razvivayushchegosya mozga [The effect of propofol on the hippocampus of the developing brain]. Eksperementalnaya nevrologiya – Experimental Neurology, 7 (3), 42-46 [in Russian].

Nikishova, I.M., Mishchenko, V.M., & Kutikov, D.O. (2019). Mekhanizmy formuvannia ta suchasni pryntsypy terapii nevrolohichnykh rozladiv [Mechanisms of form and principle of therapy of neurological careers]. 1 (98), 20-26 [in Ukrainian].

Yakhno, N.N., & Zakharov, V.V. (2010). Narusheniye kognitivnykh funktsiy. Nevrologiya: natsionalnoye rukovodstvo [Cognitive impairment. Neurology: national leadership]. 10, 532-547 [in Russian].

Backman, M.E., & Kopf, A.W. (1986). Iatrogenic effects of general anesthesia in children: considerations in treating

large congenital nevocytic nevi. J. Dermatol. Surg. Oncol., 12 (4), 363-367. doi:10.1111/j.1524–4725.1986.tb01921.x.

Bartels, M., Althoff, R.R., & Boomsma, D.I. (2009). Anesthesia and cognitive performance in children: no evidence for a causal relationship. Twin Res. Hum. Genet., 12 (03), 246-253. doi:10.1375/twin.12.3.246.

Burkhart, C.S. (2012). Can postoperative cognitive dysfunction be avoided? Hosp pract. (Minneap), 40 (1), 214-223.

Lobov, M., Knyazev, A., & Ovezov, A. (2010). Perioperative prevention of early cognitive dysfunction in children. Intensive Care Medicine, 36 (Suppl. 2), 276.

Meixensberger, J., Dings, J., & Hamelbeck, B. (1995). Monitoring of cerebral oxygenation by near infrared spectroscopy vs brain tissue PO2 and cerebral perfusion pressure following severe head injury. Proc. Int. Cereb. Hemodyn. Symp., (of North America).

Mchedlishvili, G.I. (1998). Arterial behavior and blood circulation in the brain.

Prokhno, O.I. (2014). Clinical and psychological basis of indications for oral cavity sanation in children of different ages under general anesthesia. International Conference Materials Methods and Technologies, 8.

Rasmussen, L., Stygall, J., & Newman, S. (2010). Cognitive dysfunction and other long-term complications of surgery and anesthesia. Miller’s Anesthesia, (7), 28052819. doi:–0–443–06959–8.00089–3.

Reynolds, E.O.R., Wyatt, J.S., Azzopardi, D., Delpy, D.T., Cady, B., Cope, M., & Wray, S. (1988). New noninvasive methods for assessing brain oxygenation and haemodynamics. Brit. Med. Bull., 1052-1075.

Verhagen, E.A., Van Braeckel, K.N., & van der Veere, C.N. (2015). Cerebral oxygenation is associated with neurodevelopmental outcome of preterm children at age 2-3 years. Dev. Med. Child Neurol., 57 (5), 449-455. Doi: 10.1111/dmcn.12622.

How to Cite
Koval, O. I. (2019). Assessment of the oxygen status of the brain during the oral cavity sanation in children aged 3–7 years under general anesthesia on an outpatient setting. Clinical Dentistry, (2), 50-58.
Children’s stomatology