Adverse Events Associated with Sedation and General Anesthesia in Pediatric Dentistry: A Systematic Review

Background and Objectives: A systematic review investigated adverse event frequencies and types occurring during pediatric dental sedation and general anesthesia administration to children using different medications through multiple delivery methods. Methods: A complete database search based on PRISMA guidelines spanned from 2015 until 2024. The initial screening process yielded 211 articles which was reduced to 20 studies comprising three RCTs and seventeen crosssectional types. The evaluation of bias risk applied the ROBINS-E along with RoB 2.0 assessment tools. Results: Twenty studies were assessed for the research with 13 featuring data about GA and 7 providing data about PDS. The sedative agents commonly selected for sedation included propofol, sevoflurane, ketamine and midazolam. Data showed a wide range of adverse event incidence between 8% to 47.5% that included agitation at 47.5% and postoperative pain reaching 90% and nausea affecting 19.6% and laryngospasm that rose up to 36.8%. Cognitive and financially speaking office-based sedation proved better than treating patients with GA. Conclusion: Successful reduction of adverse events depends on selecting suitable patients followed by personalized sedation methods and continuous intraoperative alongside postoperative surveillance. Professional sedation guidelines along with specialized pediatric dental sedation training demonstrably need implementation according to this research.