Our Experience with Sevoflurane in Pediatric Dental Patients

Background. Pediatric oral surgery, especially removal of impacted teeth, is a common oral procedure and anesthesia management becomes a critical task to ensure a smooth surgery and minimize the child's discomfort. In recent years, with the development of anesthesiology and the emergence of new anesthetic drugs, the choice of anesthetics has become more diverse. Among them, sevoflurane, as an inhalation anesthetic with rapid onset and recovery, has attracted increasing attention for its safety and comfort in children. Sevoflurane can not only ensure a stable anesthetic condition, but also shorten the postoperative recovery time and reduce the risk of postoperative aspiration and vomiting and other adverse reactions, which helps improve anesthetic care in children. The aim of the study was to compare the effects of the traditional technique of inhalation induction and maintenance of anesthesia VIMA (Volatile Induction and Maintenance Anesthesia) and the new technique VIMA with double bolus induction with sevoflurane on the incidence of complications such as bradycardia and agitation in pediatric dental patients. Material and methods The study included 160 children aged 3 to 14 years who underwent dental treatment (treatment of multiple caries and tooth extraction) under sevoflurane inhalation anesthesia (traditional VIMA technique). The patients were divided into 2 groups depending on the anesthesia technique: in group 1 (n=80), treatment/tooth extraction was performed using the standard VIMA technique, and in group 2 (n=80), using a new method of inhalation anesthesia, with double block induction of sevoflurane. Research results During the study, we also identified the economic effect of using double bolus induction of sevoflurane by assessing the induction time before intubation and transfer of the patient to mechanical ventilation. Thus, when using the traditional VIMA technique, this time was 4.0-5.5 minutes, and with double bolus induction, 2.0-2.5 minutes (the first bolus was performed in 30 seconds and the second bolus in 1.5-2.0 minutes). Conclusions The VIMA technique with sevoflurane double bolus induction of anesthesia is cost-effective in children undergoing dental procedures. The VIMA technique with sevoflurane and double bolus induction of anesthesia provides a preconditioning effect and reduces the incidence of complications such as bradycardia, agitation and excitation in children.