Perianesthetic dental injuries: Analysis of incident reports

被引:62
作者
Givol, N
Gershtansky, Y
Halamish-Shani, T
Taicher, S
Perel, A
Segal, E [1 ]
机构
[1] Tel Aviv Univ, Sackler Sch Med, Chaim Sheba Med Ctr, Dept Anesthesiol & Intens Care,ICU, IL-52621 Tel Aviv, Israel
[2] Tel Aviv Univ, Goldshlager Sch Dent Med, Dept Oral & Maxillofacial Surg, IL-52621 Tel Aviv, Israel
[3] Med Risk Management Co, Tel Aviv, Israel
关键词
anesthesia; general; intubation; complications; dental trauma; dental injury;
D O I
10.1016/j.jclinane.2003.06.004
中图分类号
R614 [麻醉学];
学科分类号
100217 [麻醉学];
摘要
Study Objective: To conduct a retrospective analysis of incident reports concerning dental injury, the most common cause for litigation against anesthesiologists, to determine specific risk factors that will help in formulating a risk reduction strategy for this clinical problem. Design: Retrospective chart review of a large professional liability insurer. Interventions: Of 40 hospitals that report to the MRM Co. as part of the professional liability insurance, during the years 1992-1999, 18 hospitals reported dental injury. A Maxillofacial surgeon (GN) and an anesthesiologist (ES), using a structured form, reviewed the reports. Evaluation of the cost of injury was determined from the patient's claims or from an evaluation of rehabilitation plan constructed by the maxillofacial surgery consultants to the company. Measurements and Main Results: There were 203 incidents due to dental injury. The patients were most commonly in their 5(th) to 7(th) decade. Eighty six percent of the injured teeth were the upper incisors. Lower incisors were more likely to be injured during an urgent intubation, or due to airway manipulation other than intubation. (i.e., oral airway insertion) In only 38 (18.6%) cases was there a previous assessment of an expected difficult intubation. Dentition was judged to be pathological in 32% of the patients. Conclusions: In elective intubation, the teeth most likely to be injured are the upper incisors, in patients aged 50-70 years. In most cases dental injury is not associated with a pre-event prediction of difficult intubation. (C) 2004 by Elsevier Inc.
引用
收藏
页码:173 / 176
页数:4
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