Paediatric Dental Anaesthesia, Special Needs Patients, and Outpatient Sedation — WACS Viva & Clinical Scenarios (Plastics & Dental)
Exam-style paediatric dental anaesthesia, special needs patients, and outpatient sedation viva scenarios with examiner probes and model answers for ANAESTHESIA…
Scenarios covered
- SCENARIO 1: A 3-year-old uncooperative child weighing 14 kg is scheduled for day-care full-mouth dental rehabilitation under general anaesthesia. The procedure involves multiple extractions and stainless-steel crown placements requiring a nasotracheal tube and throat pack. Outline your pre-anaesthetic evaluation, technique for atraumatic nasotracheal intubation, throat pack safety protocol, and recovery discharge criteria.
- SCENARIO 2: An 8-year-old boy with Down syndrome (Trisomy 21) and a history of surgically repaired ventricular septal defect (VSD) in infancy presents for extensive dental restorations. He has severe intellectual disability, macroglossia, chronic nasal discharge, and a history of loud snoring. Detail your comprehensive anaesthetic plan, highlighting anatomical, cardiac, atlanto-axial, and post-extubation considerations.
- SCENARIO 3: A 6-year-old girl weighing 20 kg is undergoing dental extractions under deep sedation with propofol and local anaesthesia administered by the dental surgeon. Ten minutes into the procedure, after the dentist injects 4 cartridges of 2% lidocaine with 1:80,000 adrenaline, the child becomes restless, develops perioral twitching, followed by a generalized tonic-clonic seizure, bradycardia, and wide-complex ventricular dysrhythmias. What is your immediate diagnostic analysis and resuscitation protocol?
- SCENARIO 4: A 14-year-old with spastic quadriplegic cerebral palsy, seizure disorder on sodium valproate, and severe gastroesophageal reflux disease (GERD) is scheduled for elective dental scaling and extractions. Outline your pre-anaesthetic workup, aspiration prophylaxis, anaesthetic induction, intraoperative positioning, and postoperative management plan.