Pediatric dentists preference of general anesthesia endotracheal intubation route and their perception of a modified oral intubation technique

Abstract

Aim: Pediatric airway management in light of notable modifications in endotracheal anesthesia armamentarium is an essential aspect in the pediatric population undergoing general anesthesia (GA). We aimed to assess Gulf Cooperation Council (GCC) pediatric dentists’ preference of GA endotracheal intubation and their perception regarding a modified technique of oral intubation using a Ring, Adair and Elwyn “RAE” tube during dental treatment under general anesthesia.

Methods: A web-based questionnaire was circulated via social media platforms and emails to pediatric dentists practicing in the GCC. It included demographic variables and questions about preference, familiarity and perception of pediatric dentists related to a modified oral intubation method using an oral RAE tube. Responses were analyzed by using χ2 and Exact Fischer’s test. Statistical significance was set as p <0.05.

Results: A total of 73 pediatric dentists who perform dental treatment under GA responded. Male pediatric dentists were more familiar with RAE tube than females (p=0.031). Sixty-four percent of respondents (n=18) within the age 36-45 agreed on the proposed modified technique (p=0.027). Over 83.3% (n=15) out of 18 with ≥ 21 years of experience believed that the modified technique will cause difficulty when compared to nasal intubation (n=0.009).

Conclusion: The results of this study indicated that 79.5% of the studied sample considered nasal intubation as the route of choice, despite the fact that they believe it was associated with more complications. The majority of GCC pediatric dentists were unfamiliar with the RAE tube. Interestingly, these results showed 50.7% level of agreement in utilizing a modified oral intubation technique using RAE tube. Therefore, it is recommended that further research should be undertaken and hands on workshops are conducted to familiarize GCC pediatric dentists with the feasibility and easiness in performing dental procedures under GA without tube interference.