Prospective audit of sedation/anesthesia practices for children undergoing computerized tomography in a tertiary care institute.
Adverse events
CT suite
pediatric sedation
sedative drugs
Journal
Journal of anaesthesiology, clinical pharmacology
ISSN: 0970-9185
Titre abrégé: J Anaesthesiol Clin Pharmacol
Pays: India
ID NLM: 9516972
Informations de publication
Date de publication:
Historique:
received:
21
01
2019
revised:
25
05
2019
accepted:
03
09
2019
entrez:
5
10
2020
pubmed:
6
10
2020
medline:
6
10
2020
Statut:
ppublish
Résumé
The aim of the study was to enumerate the sedative drugs used, assess the efficacy of sedative drugs, and determine the incidence of adverse events. A prospective audit of children sedated for computerized tomography (CT) by anesthesiology team was conducted for a period of 4 months. The data included patient demographic variables, fasting period, medications administered, adequacy of sedation, imaging characteristics, adverse events, and requirement for escalated care. A total of 331 children were enrolled for sedation by the anesthesia team. The drugs used for sedation were propofol, ketamine, and midazolam. Twenty-two percent children received one sedative drug, 60% children were administered two drugs, and 5% children required a combination of all three drugs for successful sedation. Sedation was effective for successful conduct of CT scan in 95.8% patients without the requirement of a repeat scan. Twelve (5%) children experienced adverse events during the study period. However, none of the adverse events necessitated prolonged postprocedural hospitalization or resulted in permanent neurologic injury or death. The current practice of sedation with propofol, ketamine, and midazolam, either single or in combination was efficacious in a high percentage of patients. The incidence of adverse events during the study period was low.
Sections du résumé
BACKGROUND AND AIMS
OBJECTIVE
The aim of the study was to enumerate the sedative drugs used, assess the efficacy of sedative drugs, and determine the incidence of adverse events.
MATERIAL AND METHODS
METHODS
A prospective audit of children sedated for computerized tomography (CT) by anesthesiology team was conducted for a period of 4 months. The data included patient demographic variables, fasting period, medications administered, adequacy of sedation, imaging characteristics, adverse events, and requirement for escalated care.
RESULTS
RESULTS
A total of 331 children were enrolled for sedation by the anesthesia team. The drugs used for sedation were propofol, ketamine, and midazolam. Twenty-two percent children received one sedative drug, 60% children were administered two drugs, and 5% children required a combination of all three drugs for successful sedation. Sedation was effective for successful conduct of CT scan in 95.8% patients without the requirement of a repeat scan. Twelve (5%) children experienced adverse events during the study period. However, none of the adverse events necessitated prolonged postprocedural hospitalization or resulted in permanent neurologic injury or death.
CONCLUSIONS
CONCLUSIONS
The current practice of sedation with propofol, ketamine, and midazolam, either single or in combination was efficacious in a high percentage of patients. The incidence of adverse events during the study period was low.
Identifiants
pubmed: 33013027
doi: 10.4103/joacp.JOACP_16_19
pii: JOACP-36-156
pmc: PMC7480298
doi:
Types de publication
Journal Article
Langues
eng
Pagination
156-161Informations de copyright
Copyright: © 2020 Journal of Anaesthesiology Clinical Pharmacology.
Déclaration de conflit d'intérêts
There are no conflicts of interest.
Références
Clin Radiol. 1997 Dec;52(12):945-7
pubmed: 9413970
Am J Emerg Med. 2002 Sep;20(5):463-8
pubmed: 12216045
Paediatr Anaesth. 2004 Mar;14(3):256-60
pubmed: 14996266
Pediatrics. 2016 Jul;138(1):
pubmed: 27354454
Curr Opin Anaesthesiol. 2007 Aug;20(4):365-72
pubmed: 17620847
Anesthesiology. 2017 Mar;126(3):376-393
pubmed: 28045707
J Nurs Res. 2004 Mar;12(1):31-40
pubmed: 15136961
Anesth Analg. 2009 Mar;108(3):795-804
pubmed: 19224786
Paediatr Anaesth. 2007 Jul;17(7):661-6
pubmed: 17564648
BMJ Open. 2017 Jun 30;7(6):e013402
pubmed: 28667196
Br J Anaesth. 1974 Jan;46(1):66-8
pubmed: 4406274
Paediatr Anaesth. 2015 Jan;25(1):36-43
pubmed: 25280003
Pediatr Radiol. 2012 Feb;42(2):183-7
pubmed: 21861089
Anesthesiology. 2018 Mar;128(3):437-479
pubmed: 29334501
Pediatr Crit Care Med. 2015 Jan;16(1):11-20
pubmed: 25340297
Br J Anaesth. 2017 Mar 1;118(3):407-414
pubmed: 28203729
J Clin Nurs. 2010 Jun;19(11-12):1604-11
pubmed: 20384669
Paediatr Anaesth. 1995;5(6):375-8
pubmed: 8597970
Pediatr Radiol. 2008 Mar;38(3):260-4
pubmed: 18175110
Pediatr Radiol. 2002 May;32(5):348-53
pubmed: 11956723
Pediatr Emerg Care. 2012 Oct;28(10):1003-8
pubmed: 23023464
J Pediatr. 2012 May;160(5):801-806.e1
pubmed: 22177990