Clinical evaluation of intravenous sedation in pediatric endoscopic procedures: A retrospective observational study Sedation in Pediatric endoscopic procedures
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Objective: The main benefits of sedation are to reduce the patient’s anxiety and discomfort, to improve their tolerability. The aim of study was evaluate intravenous sedation for pediatric gastrointestinal endoscopic procedures
Materials and Methods: We analyzed patients’ data, who underwent gastrointestinal endoscopic procedures in our pediatric endoscopy unit, retrospectively. All gastrointestinal endoscopic procedures were performed by a pediatric gastroenterologist and sedations were managed by an anaesthesia team, including two staff anesthesiologists.
Results: During the study period, 530 gastrointestinal endoscopic procedures were performed. 461 (87%) were esophagogastroduodenoscopy, 56 (10.6%) were both esophagogastroduodenoscopy and colonoscopy and 13 (2.5%) were percutaneous endoscopic gastrostomy. Propofol was given all of the patients either as a single drug (6 patients, 1%) or in combinations (77.4% with midazolam; 12.3% with ketamine and 9.2% with fentanyl). Overall adverse event rate due to sedation was 19.6%, but no serious side effects were documented. The most frequent side effects were injection pain (10.4%), and nausea (7.5%). Allergic reactions were experienced in 1.3% patients and resolved with methylprednisolone and antihistaminic medications. Respiratory depression was observed in only two girls (3 and17 years old) and did not need advanced interventions to control the problem. Seven patients’ gastroscopies were interrupted by gastroenterologist due to gastric content in order to prevent vomiting and aspiration.
Conclusions: Intravenous sedation for pediatric gastrointestinal endoscopic procedures can be applied safely and successfully with a trained team and organized endoscopy unit.
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