Background: Nasotracheal intubation (NTI) is the standard used technique for treating children's teeth under general anaesthesia (GA). Nevertheless, it may cause adverse effects like laryngeal pain, post-operative nausea and vomiting (PONV), and dysphonia. Hence, this study aimed to compare the pediatric dentist's access to the mouth, PONV, laryngeal pain, dysphonia, patients' recovery time, parents satisfaction and operators satisfaction for children received NTI or an LMA.
Materials and methods: Fifty children were randomised to either NTI or LMA groups. One expert pediatric dentist performed full mouth rehabilitation for all children. An expert anaesthetist used 8% sevoflurane mask for induction, followed by airway management either with LMA or NTI. Muscle relaxant was not administered for both groups to permit lung muscles to work normally during operation.
Results: The baseline characteristics were similar between NTI and LMA with no statistically significant difference. Regarding the postoperative laryngeal pain and dysphonia, LMA showed less risk of occurrence with a relative risk of 0.27 (95% CI: 0.1, 0.69) and 0.22 (95% CI: 0.1, 0.5) respectively, and these results were statistically significant (P<0.01). On the other hand, the use of NTI decreased the total operation time by 23 minutes (95% CI:14.8, 31.2). Besides, NTI resulted in better intraoral accessibility for the pediatric dentist with 92% rating as excellent, while LMA was obstructing the view in 40% of cases and prevented working efficiently in 32% of cases. There were no statistically significant differences between the two groups in the incidence of PONV, dental pain scores, recovery time, or parents' satisfaction level (P>0.05).
Conclusion: For this group of Egyptian children who underwent full-mouth dental rehabilitation under general anaesthesia, the LMA provided less risk for postoperative laryngeal pain and dysphonia. However, the pediatric dentist had better accessibility and workability with NTI, which subsequently decreased the operation time significantly.