Abstract
Dental treatment under GA is a compelling method for giving therapeutically important consideration to those youngsters who might be intellectually juvenile, exceptionally restless, medicinally split the difference, or unfit to get treatment in a customary office setting. While the traditional work on concerning corticosteroids is likely innocuous and perhaps gainful with lower prophylactic dosages and the nature of oral admission was additionally unaffected. The study aimed to investigate commonly prescribed corticosteroids in children undergoing full-mouth dental management under general anesthesia. A single-centered retrospective study among pediatric patients treated under general anesthesia of the age group of 0–13 years. The sample size is 124. Data were collected and tabulated. Data were statistically analyzed using the SPSS software version 23. Chi-square test and Pearson correlation were done using the software and P < 0.05 was considered statistically significant. The results show that 79.67% commonly prescribed dexamethasone, whereas 20.33% use hydrocortisone, providing the age groups between 0 and 3 has higher prescribing of corticosteroids. From this study, it is concluded that since the P value was more than 0.05, there is no significant statistical difference that has been analyzed. Dexamethasone is the commonly prescribed corticosteroid in children undergoing full-mouth rehabilitation under GA, followed by hydrocortisone.
Keywords: Children's, corticosteroids, general anesthesia, novel approach
INTRODUCTION
General sedation is a reversible condition of obviousness created by sedative specialists, with loss of torment sensation over the whole body. General sedation for the most part utilizes a combination of intravenous medications and breathed in gasses. Dental specialists treat most pediatric patients satisfactorily utilizing conduct strategies. Nonetheless, certain youngsters cannot get treatment through these strategies. Full-mouth rehabilitation under general anaesthesia (GA) may be a recuperation treatment for children.[1] it is been just about 30 years that sweeping dental recuperation under GA has been proposed to pediatric people.[2,3] In a couple of cases, dental GA is the most realistic and common sense strategy for treatment.[4] Consistent with the American Academy of Pediatric Dentistry (AAPD), the children who will likely not persevere through dental treatment on the chairside should be managed under GA. Children who are lacking cooperative ability including children of very young age and those encountering physical and mental insufficiency are managed using GA to supply remedially crucial care.[5] The weight of dental GA contenders are adolescents that experience the evil impacts of one prevalent shortcoming, Early childhood caries (ECC), and are by and large sound.[6,7,8,9] This rising natural market is inherently associated with more risks and intricacies. Most pediatric populations report fights following dental GA frameworks of various earnestness.[10] Dental torment, trouble in eating, nasal dying, throat uneasiness, nose distress, rest modification, shortcoming, sluggishness, parchedness, fever, queasiness, regurgitating, roughness, runs, and clogging are a few announced postoperative inconveniences. These unfavorable reactions could likewise be limited, yet not totally wiped out (AAPD).[11] Practitioners ought to have top-to-bottom information on the specialists planned to utilize and their related complexities.
Corticosteroids are one of the broadly involved drugs in dentistry. The reasoning for its utilization is its mitigating likewise immunosuppressive properties. Corticosteroids are normally endorsed in youngsters going through dental treatment under broad sedation. The use of glucocorticosteroids is recommended to stop postoperative sickness and spewing. Moreover, the glucocorticosteroids-related lessening of postoperative agony, likewise as enhancements in mindset and exhaustion are demonstrated. Ordinarily utilized steroids are hydrocortisone, dexamethasone, methylprednisolone, prednisolone, and so on. Corticosteroids are viewed as a two-sided deal to the patients.[12] Regardless of their different benefits, they even have extreme incidental effects. Secondary effects are guided to the sort and measurement of the medication and length of treatment. These medications are one of the chief abused drugs inside the kind of measurement. Dental corticosteroids could likewise be retained through the coating of the mouth and, whenever utilized time after time or for a really long time period, may impede development in youngsters, disabled balance, and hypertension. Albeit not those aftereffects might happen on the off chance that they truly do happen they will require clinical consideration. The review intends to investigate the usually recommended corticosteroids in kids going through dental treatment under broad sedation. Our research and knowledge have resulted in high-quality publications from our team.[13,14,15,16,17,18]
MATERIALS AND METHODS
Study design
The present study was designed to be conducted as a retrospective study in a single dental institution in Chennai. The study was conducted after getting approval from the Institutional Ethical Committee, Saveetha Dental College-IHEC/SDC/PEDO/21/011.
Data collection
Data for the present retrospective study were collected from the records of children <13 years of age, who underwent dental treatment under general anesthesia between September 2020 and February 2021 in the institution. Records of 124 children who fulfilled the inclusion criteria were analyzed. Demographic details and commonly prescribed corticosteroids were collected and transferred into Excel sheets.
Statistical Analysis
Statistical software used was SPSS IBM version 23.0 (IBM SPSS Statistics, Version 20.0, Arming, NY: IBM Corp.). Statistical analysis used was descriptive statistics of frequency distribution. The correlation analysis used was the Chi-square test. The Pearson's Chi-square value and P value were determined. A significant P value was set at <0.05. All the data were collected and analyzed statistically and graphically represented and discussed.
RESULTS
The demographic details of the participants of the present study is depicted in Table 1. In the present study, it was seen that Dexamethasone was the corticosteroid that was most commonly used in about 79.67% of the cases, whereas hydrocortisone was used in 20.33% of the cases. This is depicted in Graph 1. The bar chart in Graph 2 represents the correlation between age group and predominantly prescribed corticosteroids in children undergoing dental treatment under general anesthesia. X-axis represents the age group; Y-axis represents the number of participants. Chi-square test was done and the association was found to be statistically insignificant. Person's Chi-square value is 4.700, df: 2, P value: 0.864 (>0.05) hence statistically insignificant. Blue represents dexamethasone; green represents hydrocortisone. Providing age group between 0 and 3 has higher prescribing of corticosteroids.
Table 1.
Demographic details
| Age | 2.89+2.45 |
|---|---|
| Gender | Male - 47.15% |
| Female - 52.85% |
Graph 1.
Percentile distribution of commonly used corticosteroids
Graph 2.
Percentile distribution of commonly prescribed corticosteroids between age groups
DISCUSSION
Among 124 children aged between 0 and 13 years, who fulfilled the inclusion and exclusion criteria 47.15% were boys and 52.85% were girls.
According to the study, the commonly prescribed corticosteroid in the pediatric population undergoing full-mouth dental management under general anesthesia was dexamethasone (79.67%).
The apparently constructive outcome of dexamethasone on the postoperative nature of recuperation is clinically conceivable due to its calming properties and antiemetic properties that decrease torment and expand following oral strategies. Hooley and Hohl announced that the utilization of corticosteroids is huge, yet urgent and no big surprise, cortisol (hydrocortisone) is known as the life-safeguarding chemical.[19]
Dexamethasone is viewed as one of the ideal medications being promptly accessible and modest, with immunosuppressive properties that forestall and treat postoperative sickness, retching (PONV), advanced hunger, and stifle inflammation. The generally antagonistic impacts of dexamethasone are intriguing and its advantages out-gauge the dangers implied.
CONCLUSION
Dexamethasone is the commonly prescribed corticosteroid in the pediatric population undergoing full-mouth dental management under general anesthesia, followed by hydrocortisone.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
Acknowledgments
We would like to thank Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Science, and Saveetha University.
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