Cerebral oximetry as a method for monitoring oxygen saturation of the brain in children aged 7–12 years with rehabilitation of the oral cavity under general anesthesia on an outpatient basis
DOI:
https://doi.org/10.11603/2311-9624.2019.4.10882Keywords:
cerebral oximetry, SpO2, rSO2, general anesthesiaAbstract
The article presents the results of the assessment of the oxygen status of the brain during the period of rehabilitation of the oral cavity in conditions of general anesthesia.
The aim of the study – the necessity of a time limit in children aged 7–12 years is substantiated in order to prevent the occurrence of cognitive dysfunctions of the brain against the background of hypoxic lesions.
Materials and Methods. Assessment of the oxygen status of the brain during the rehabilitation of the oral cavity in conditions of general anesthesia (without intubation) was conducted on 31 children aged 7–12 years at the Dental Medical Center at the National Medical University named after O. Bohomolets using neuromonitoring method – cerebral oximetry (blood gas monitoring device: 4-channel regional oximeter with EQUANOXTM technique, Bluetooth wireless technology and RS-232 (model 7600) (State Registration Certificate No. 12580/2013. Producer : Nonin Medical, Inc., USA).
Results and Discussion. The decrease in rSO2 occurs with 40 min. The minimum value of rSO2 = 60.44 %. Identical to the minimum rSO2 value (60.44±0.46) % is between 55 and 56 min. During the dental intervention under general anesthesia, complications in the form of laryngospasm were noted in 12.9 %. Among children who had a history of laryngospasm complications, 75 % had a history of less than 2 weeks after complete recovery for acute respiratory disease (ARD). Therefore, we considered that inflammatory processes of the respiratory mucosa play a significant role in the occurrence of laryngospasm against the background of age-related features of their anatomical structure. When laryngospasm rSO2 is (70.69±6.47) %, which is 6.42 % relative to the mean rSO2 of the respective age group (rSO2 = (75.54±2.27) %. The decrease in rSO2 is observed from 11 minutes. To 28 min. (≤20 min) is 8.26 % (rSO2 = (64.85±3.51) %. The maximum decrease occurred in 17 minutes (rSO2 = (60.25±4.08) %, accounting for 14.77 % of the total value (р˂0.05) and 7.09 % of the rSO2 index directly for laryngospasm. Therefore, the presence of a history of acute respiratory illness in children aged 7–12 years limits the provision of dental care in an outpatient setting under general anesthesia.
Conclusions. The method of cerebral oximetry is an informative method of neuromonitoring when the behavior of oral sanitation under conditions of general anesthesia is performed. Dental rehabilitation of the oral cavity on an outpatient basis under general anesthesia for children aged 7–12 years should be carried out within (40±15) min. A contraindication to scheduled oral sanitation under general anesthesia in outpatient settings for children aged 7–12 years has acute respiratory infections in the anamnesis of less than 2 weeks. If there is a history of acute respiratory infections in less than 2 weeks and an acute dental need, emergency care under general anesthesia in outpatient settings for children aged 7–12 years is possible within 10 min.
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