15 - Use of Local Anesthesia in Pediatric Oral Rehabilitation Cases Under General Anesthesia

The use of local anesthesia (LA) during pediatric dental rehabilitation under general anesthesia (GA) remains a subject of clinical debate due to a lack of standardized, interdisciplinary guidelines. While proponents emphasize benefits like hemostasis and reduced physiologic stress, concerns regarding postoperative self-injury and emergence agitation contribute to significant practice variability. This study aimed to characterize current practice patterns and decision-making factors by comparing the perspectives of U.S. pediatric dentists and dentist anesthesiologists.

An anonymous national survey distributed via the American Academy of Pediatric Dentistry (AAPD) and American Society of Dentist Anesthesiologists (ASDA) listservs assessed the frequency of LA use, clinical rationales, and perceptions of risk versus benefit. Descriptive statistical analysis, performed by one of the study’s investigators will compared attitudes and practice patterns between pediatric dentists and dental anesthesiologists. Results indicated a clear divergence in practice: dentist anesthesiologists reported using LA significantly more frequently and were more likely to support its routine use than pediatric dentists. Clinical priorities also differed by specialty, with pediatric dentists placing a higher value on intraoperative hemostasis. A strong interdisciplinary consensus emerged regarding recovery, with a majority of both groups agreeing that LA does not significantly impact postoperative recovery time.

These findings highlight a distinct gap in clinical priorities between surgical and anesthesia providers. Identifying these areas of divergence is an essential step toward improving interdisciplinary communication and developing evidence-based guidelines to optimize pain management and safety for pediatric patients undergoing dental care under general anesthesia.