305 - The Effects of Dental Procedures, Local Anesthesia, and Intraoperative Analgesics on PACU Pain Score after Pediatric GA

The primary purpose of this study is to investigate the association between type of dental procedure conducted intraoperatively and the amount of postoperative pain. The secondary aim is to analyze the relationship between the amount of intraoperative local anesthesia given and whether it has an effect on post-operative pain score and/or the type of and amount of postoperative medications given. The tertiary aim is to analyze the relationship between intraoperative pain medications given and whether the patient experiences pain in the PACU and what type of medication is given. This is a retrospective cohort study of 786 ASA I and ASA II CHLA patients undergoing dental surgery between 11/2018 and 12/21/2022. Patients with a pain score ≥ 1 had a higher median number of primary teeth extractions and were more likely to undergo 4-6 extractions compared to those with a pain score of 0. Patients who were given PACU opioids were more likely to have 4-6 extractions of primary teeth. This relationship was not seen in extractions of 7+ primary teeth, or extractions of permanent teeth. Patients who received opioids in the PACU tended to have a slightly higher median amount of intraoperative local anesthesia compared to those who did not receive opioids (p = 0.0141). Patients with pain scores of zero were more likely to receive intraoperative systemic pain relievers such as Ketorolac (p = 0.019) and Dexmedetomidine (p = 0.023) compared to those with pain scores of 1 or greater. Dental providers may consider preparing the medical team that patients with multiple extractions have a higher likelihood of post-operative pain. There is a trend that an increased number of primary tooth extractions leads to a higher likelihood of post-op pain and hence a need for post-operative opioids. Intraoperative local anesthesia may increase the likelihood of post-operative pain or discomfort. Intraoperative system pain relievers like Ketorolac and Dexmedetomidine may reduce the likelihood of post- operative pain.