A pediatric sedation/anesthesia program with dedicated care by anesthesiologists and nurses for procedures outside the operating room

Gozal, David; Drenger, Benjamin; Levin, Phillip D.; Kadari, Avishag; Gozal, Yaacov

doi:10.1016/j.jpeds.2004.01.044

Cited by 75 publications

(56 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This can largely be explained by differences in definitions [16], standards of care, the provider of sedation [15,[17][18][19], and sedation technique [20][21][22][23][24]. Previous cohorts have also included children undergoing painful or nonpainful procedures, and those involving the airway such as dental surgery or upper airway endoscopy, all of which require a wide variety of techniques, drugs and doses [25].…”

Section: Discussionmentioning

confidence: 99%

Incidence and risk factors for adverse events during anesthesiologist-led sedation or anesthesia for diagnostic imaging in children: a prospective, observational cohort study

et al. 2015

View full text Add to dashboard Cite

Background: Pediatric sedation for diagnostic radiological procedures remains the mainstay for adequate imaging quality. Objectives: To clarify the risk of adverse events during anesthesiologist-led sedation or anesthesia for diagnostic radiological procedures in children in order to improve quality of care. Methods: We enrolled children aged <15 years given sedation or anesthesia by an anesthesiologist and scheduled for computed tomography, magnetic resonance imaging, or nuclear medicine imaging November 2010-September 2014. We recorded adverse events occurring in the first 24 h. Results: Of 1,042 patients enrolled, adverse events were recorded in 254 (24.4%, 95% confidence interval [CI] 21.9 to 27.1). Adverse respiratory events occurred in 31 (3.0%), cardiovascular events in 7 (0.7%), sedation was prolonged in 165 (15.8%), there was one case of contrast allergy (0.01%), and there were 50 other minor complications (4.9%). Of the respiratory complications, there were 14 of airway obstruction (1.3%), 2 of apnea (0.2%), 14 of oxygen desaturation (1.3%), and one of laryngospasm (0.01%). There were no life threatening complications or consequences. Age <1 year (adjusted odds ratio [adjusted OR] 2.5, 95% CI 1.2 to 5.3) and American Society of Anesthesiologists (ASA) physical status classification 2 and 3 (adjusted OR 4.6, 95% CI 1.1 to 19.8, and adjusted OR 6.3, 95% CI 1.3 to 30.9, respectively) were risk factors for respiratory complications. Conclusions: Adverse events were common during sedation or anesthesia, but no life threatening or sentinel events occurred under experienced supervision. Caution should be exercised in children <1 year or with an ASA classification >1.

show abstract

Section: Discussionmentioning

confidence: 99%

Incidence and risk factors for adverse events during anesthesiologist-led sedation or anesthesia for diagnostic imaging in children: a prospective, observational cohort study

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Oral triclofos has been successfully used in doses of 75-100mg/ kg. 4,9 Gozal D reported safe use of 100mg/kg triclofos in a hospital over a period of six years for many pediatric procedures outside the operating room. 4 Oral midazolam is more commonly used as a premedicant drug and has been used in the dose range of 0.25 to 1.0 mg/kg in children.…”

Section: Discussionmentioning

confidence: 99%

“…4 More recently, Oral midazolam is being widely used and found as safe and effective premedication which provides rapid onset and does not prolong recovery room stay. 5 Various studies have reported safety of oral midazolam in doses ranging from 0.5 mg/kg to 1.0 mg/kg.…”

Section: Introductionmentioning

confidence: 99%

Oral midazolam versus oral triclofos for sedation of children for computed tomography scan - a randomized clinical trial

Gupta

Pandey

Choudhry

et al. 2015

J. Soc. Anesth. Nep.

View full text Add to dashboard Cite

Background: Effective and safe pediatric procedural sedation is still a concern especially in areas outside operation theatres. The aim of the study was to compare the efficacy and safety of oral triclofos and oral midazolam in children undergoing computed tomography.Methods: A prospective randomized double blind study was conducted in 100 children aged one to five years. Group-I (n=50) received oral triclofos 100 mg/kg and Group-II (n=50) oral midazolam 0.75 mg/kg. Both groups were given oral atropine 0.03 mg/kg and supplemented with intravenous midazolam upto 0.1 mg/kg in case of inadequate effect. Onset and duration of sedation, success for completion of procedure and time to recovery were noted. Student’s t test and Z test of proportions were used for statistical analysis.Results Majority of children 36(72%) in Group-I achieved Ramsay Sedation Score >4 as compared to 25(50%) in Group-II. Computed tomography scan could be successfully completed at comparable rate (52% vs 56%). Success rate improved to 96% vs 80% after supplementing intravenous midazolam in Group I & II respectively (p< 0.05). Onset (37.91minutes ± 7.96 vs 26 ± 10), duration of sedation ( 117.91minutes ± 72.41 vs 66.2minutes ± 33) were significantly shorter and recovery (98.19minutes ± 72.58 vs 47.4minutes ± 31.42) in Group I & II respectively was faster in children who received oral midazolam (p< 0.05).Conclusion We conclude that both drugs were equally effective and safe for computed tomography scan in children. However better recovery profile of midazolam makes it more suitable for day care procedures.Journal of Society of Anesthesiologists of Nepal 2015; 2(2): 41-45

show abstract

“…Patients and families may avoid repeat hospital visits for inadequate or incomplete procedures or studies, which may contribute to overall patient and family satisfaction. 8,9 It would be of questionable value to be sedating larger numbers and potentially higher-risk patients if this more aggressive approach to sedation led to higher complication rates. This study shows the opposite to be true.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a Pediatric‐sedation Service for Common Diagnostic Procedures

King

Stockwell

DeGuzman

et al. 2006

Academic Emergency Medicine

View full text Add to dashboard Cite

Background: Pediatric patients often require sedation for diagnostic procedures such as magnetic resonance imaging and computed tomography scanning. In October 2002, a dedicated sedation service was started at a tertiary care pediatric facility as a joint venture between pediatric emergency medicine and pediatric critical care medicine. Before this service, sedation was provided by the department of radiology by using a standard protocol, with high-risk patients and failed sedations referred for general anesthesia.

show abstract

A pediatric sedation/anesthesia program with dedicated care by anesthesiologists and nurses for procedures outside the operating room

Cited by 75 publications

References 23 publications

Incidence and risk factors for adverse events during anesthesiologist-led sedation or anesthesia for diagnostic imaging in children: a prospective, observational cohort study

Incidence and risk factors for adverse events during anesthesiologist-led sedation or anesthesia for diagnostic imaging in children: a prospective, observational cohort study

Oral midazolam versus oral triclofos for sedation of children for computed tomography scan - a randomized clinical trial

Evaluation of a Pediatric‐sedation Service for Common Diagnostic Procedures

Contact Info

Product

Resources

About