Reducing general anaesthetic episodes: ‘piggyback’ procedures – Birmingham Children’s Hospital experience


introduce Birmingham Children's Hospital (BCH) has a comprehensive care pathway for joint surgery under general anesthesia (GA) – the “piggyback style”. The premise behind these combined procedures is that the dental treatment is performed concurrently with another planned GA, usually by the patient's primary medical or surgical specialty or another specialty participating in the dental GA list.

Purpose The purpose of this article is to share BCH's recent experience with joint procedures and provide a model for secondary and tertiary care providers in the UK to develop their own collaborative working methods.

method Data from pediatric dentistry at Birmingham Children's Hospital from May 2021 to May 2023 were retrospectively collected. Patients were included if they had any combined surgeries.

result During this period, a total of 93 patients underwent piggyback surgery. The average age of patients treated was nine years and three months. During this period, a total of 39 patients had tooth extractions only, 19 patients had only scalings, and 12 patients had both scalings and extractions. In addition, 269 deciduous teeth and 22 permanent teeth were extracted during this period.

in conclusion BCH has a comprehensive “incidental” procedural care pathway. Future workforce planning and patient care pathways should consider joint programs and further explore this initiative to continue streamlining patient care and reducing wait lists and risks associated with GA.



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