Preventing repeat general anaesthetic procedures by piggybacking at Great Ormond Street Hospital

Title: Preventing repeat general anaesthetic procedures by piggybacking at Great Ormond Street Hospital

Abstract:

Background: General Anaesthesia (GA) is often required for paediatric dental treatments, but repeated exposure may raise safety concerns, including potential neurocognitive risks. Piggybacking, where dental team joins a medical GA list to combine procedures, offers a solution to reduce the number of GA procedures.
Aim: This project aimed to evaluate the impact of piggybacking on reducing repeat GA exposure, improving patient care, and enhancing service efficiency at Great Ormond Street Hospital (GOSH).
Objectives: The study assessed the impact on GA episodes, service efficiency, logistical challenges, and strategies for evidence-based paediatric dental care.
Method: A retrospective analysis of piggybacked procedures from January to December 2024 was conducted using hospital emails, electronic patient records, and theatre scheduling logs. Data included planned and completed cases, procedure types, involved specialties, and cancellations.
Results: Of 49 planned cases, 32 were successfully completed. The dental team joined as the secondary team in 85% of cases, preventing repeat GA episodes and avoiding 32 additional dental procedures. Patients aged 2-17 years (ASA 1-4) were treated, with ENT participating most (13 cases). Seventeen cases were cancelled due to parental withdrawal, medical issues, or other factors.
Discussion/Recommendations/Action Plan: Recommendations include improved communication with parents, better interdepartmental coordination, and increased dental staffing to meet demand.
Conclusion: Piggybacking prevented repeat GA exposure, equivalent to eight separate dental GA lists. While ENT and SNAPS were most compatible; scheduling and staffing challenges require improved coordination between teams to optimise this approach.

Biography:

Dr Rosheen Fatima graduated with a Bachelor of Dental Surgery (BDS) from University of Central Lancashire in 2022. Since qualifying, she has gained a broad range of clinical experience across multiple settings, including NHS general dental practice, community dental services, and hospital-based care. Through these roles, she has developed a strong foundation in managing diverse patient needs, with particular exposure to complex and multidisciplinary cases. In addition to her clinical work, she has contributed to the academic community through a publication in Dental Update and has presented her work a both national and international conferences.