Re: Dental Surgery Questions

[Guest guest]

MAGIC has an article on anesthesia and the RSS child which you can

order free from them (are you a member). The basic fact that you

have to always keep in your mind is that:

No RSS/SGA underweight child should be without food for more than 4

hours. Period. And some the timing is even shorter. If your

daughter is really just 16 pounds at 4 years old (I haven't been on

the listserve in about 2 weeks so I don't your daughter's history),

she is absolutely at significant risk for hypoglycemia.

The instructions are normally that any RSS/SGA child going under

anesthesia should be put on an D10IV with glucose prior to the

surgery, during surgery and afterwards until the child can eat.

THis is because almost always before anesthesia, the parents are

instructed that the child should not eat from midnight onwards.

This includes the morning when the child wakes up.... then there is

the surgery, and recovery, and suddenly you are at far more than 4

hours....

The anethesiologist also has to be aware of the mouth/mandible

problems of an RSS child (although a dental person usually knows

this). Where is the anesthesia being given?

Good luck. Salem

>

> We were just at the Ped. Dentist today and Olivia does have to

go

> in for dental surgery. I was just wondering what I need to know

> about an RSS child being put under... Does it differ from other

> children? Will the mild hypoglycemia be affected?

> I'd appreciate any info from anyone who's been there! Thanks

>

> Leah Mom to Ash 8 non-RSS and Olivia 4yrs 16 lbs.

[Guest guest]

Leah,

My son is 10 & has had lots of surgery over the years, including 7 sets of ear

tubes,

getting his adenoids out, a liver biopsy, endoscopy, g-tube & fundoplication,

broviac

catheters inserted, and I am sure the list goes on, but that's all I can think

of without

looking back at medical records. I only recently found out he has RSS, and

although

he never had glucose tolerance tests when he was younger, I suspect he had

problems with his blood sugar, because he had all the classic symptoms. Except

for

when he was an infant, he followed the typical rules for surgery which included

nothing to eat or drink after midnight. There were times when he had nothing to

eat

or drink all day, because surgery took a long time or it was postponed until

later in

the day. Although the literature I have read suggests otherwise, he never had a

problem from this that I realized. The difficulty they do have with him as far

as

anesthesia goes is intubating him. He, like most RSS kids, has a small oral

cavity and

a high-arched palate, which makes him difficult to intubate. When he had his

liver

biospy done, they knocked 2 teeth out of his mouth, because of the angle they

had to

go in with the tube. I am not sure if difficult intubation is a characteristic

of RSS

children or just particular to my son, but I thought it was worthwhile to

mention. For

dental surgery, there may not be a need to intubate anyway - maybe they'll just

use

nitrous oxide? My son did have nitrous oxide at the dentist to have a tooth

pulled,

and he had no ill effects from it.

Kim

>

> We were just at the Ped. Dentist today and Olivia does have to go

> in for dental surgery. I was just wondering what I need to know

> about an RSS child being put under... Does it differ from other

> children? Will the mild hypoglycemia be affected?

> I'd appreciate any info from anyone who's been there! Thanks

>

> Leah Mom to Ash 8 non-RSS and Olivia 4yrs 16 lbs.