Implementation Of An Enhanced Recovery After Surgery Clinical Pathway In Children Undergoing Dental Day-case Surgery Under General Anesthesia

Objective:This study was aiming to investigate the safety and efficiency of general anesthesia for children undergoing dental day-case surgery with enhanced recovery after surgery(ERAS)concept,optimize the procedure of peri-anaesthesia and accelerate the recovery of children after surgery on the premise of ensuring safety.Methods:A total of 90 pediatric the patients were consecutively enrolled into the study at Comfort Dental Center,Stomatology Hospital Affiliated ChongQing Medical University,ChongQing,China between April 2017 and July 2017.The pediatric patients were according to different methods of perioperative management,all cases were assigned into ERAS group(n=42),C group(n=42).The frequency and success rate of airway management tool insertion,intubation time,anesthesia recovery time,perioperative complications,restlessness during recovery period,postoperative pain rate and time of absence from hospital were compared between the two groups.Results:There were no significant differences in the age,weight,sex,and duration of surgical procedures between the 2 groups.Compared with two groups of patients with general information,operation time,anesthesia time is not statistically significant.ERAS group and the control group insertion times and the success rate of intubation are the same.The time of the laryngeal mask airway intubation in ERAS group was shorter than the control group(p<0.01).The recovery time of the ERAS group longer than the control group(P<0.01).However,the time of PACU stay in ERAS group significantly shorter than the control group.Pain score in ERAS group was lower than the control group(P<0.05).The surgeons' access was not different between the two groups.14 patients in the ERAS group had postoperative complications,while 2 patients had complication during the surgery.38 patients in the control group had postoperative complications,while 2 patients had complication during the surgery.Compared with the control group,the incidence of postoperative complications in ERAS group was lower and the incidence of postoperative adverse events in ERAS group was significantly lower than that in the control group.Conclusion:The general anesthesia for children undergoing dental day-case surgery with enhanced recovery after surgery(ERAS)is safe and effective.On the basis of ensuring the safety and comfort of anesthesia,it can reduce the incidence of intraoperative and postoperative complications,promote the rapid recovery of patients,reduce postoperative pain,ensure the analgesic effect and reduce the incidence of restlessness during recovery period.