Wednesday, March 14, 2018

Variables Affecting General Anesthesia Time for Pediatric Dental Cases


Variables Affecting General Anesthesia Time for Pediatric Dental Cases
Resident’s Name: Wayne Dobbins                                                                                 Date: 03-14-2018
Article Title: Variables Affecting General Anesthesia Time for Pediatric Dental Cases
Author(s): Yi Y, Lee J, Yi H, Asher S, Feldman L, Rivas-Morello C, Haque M, Ross E
Journal: Pediatric Dentistry
Date: 2015
Major Topic: Anesthesia
Type of Article:  Restrospective Chart Review
Main Purpose: Identification of variables that predict procedural times for dental treatments
Key Points: Provider inexperience, need for radiographs, older age, medical complications, and oral intubation all significantly increase procedural time.
All pediatric dental OR cases at Boston Children’s Hospital looked at from April 2009 to December 2013, excluding cleft lip and palate cases, intradisciplinary cases, and cases with incomplete data – 2266 cases used for study in total. Statistical analysis was conduted to determine significant predictors of early or late finish times as compared to the booked time; for the cases of this study a 15 minute difference qualified as early or late.

Provider inexperience, need for radiographs, older age, medical complications, and oral intubation all significantly increased the chances for late finishes. Early and late finishes did not vary significantly by academic quarter, by referrer type (resident vs attending), by gender of patient, or by time elapsed between date of referral and date of treatment.

Overestimation of pediatric dental operating room cases exists, and identification of variables associated with these inaccuracies can aid providers in recapturing underutilized operative room times.



Much of the findings of this study are most relevant to Boston Children's, as it specifically relates to the manner in which they book patients. At St. Joseph, with 2 hour blocks, the specific refinements provided by the data are not as relevant, but the notion that a formula could be created to estimate procedure length could increase efficiency.  Of course, this is just a theory and if you have spent a day in the OR at Lady of Fatima Hospital efficiency is not in their vocabulary! 

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