Independent risk factors for adverse events associated with propofol-based pediatric sedation performed by anesthesiologists in the radiology suite: a prospective observational study

• Published in: European journal of pediatrics Vol. 180; no. 5; pp. 1413 - 1422
• Main Authors: Lee, Jeong-Rim, Lee, Jae Hoon, Lee, Hye-Mi, Kim, Nayeon, Kim, Myoung Hwa
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.05.2021; Springer Nature B.V
• Subjects: Adolescent; Anesthesia; Anesthesiologists; Child; Children; Computed tomography; Conscious Sedation - adverse effects; Heart; Humans; Hypnotics and Sedatives - adverse effects; Magnetic resonance imaging; Medical personnel; Medicine; Medicine & Public Health; Observational studies; Original Article; Pediatrics; Propofol; Propofol - adverse effects; Prospective Studies; Radiology; Risk Factors; Sensitivity analysis; Pediatrics; Propofol; Sedation; Adverse events
• ISSN: 0340-6199; 1432-1076
• DOI: 10.1007/s00431-020-03916-w

This study aimed to identify the types and frequencies of adverse events, as well as the risk factors for respiratory complications related to pediatric sedation. This single-center, prospective, observational study was conducted in a radiology suite at a tertiary university hospital for 2 years. Patients aged under 18 years, who underwent sedation solely by anesthesiologists for computed tomography or magnetic resonance imaging scans, were eligible for inclusion. Univariate and multivariate logistic regression analyses were carried out to identify the risk factors of adverse events, including respiratory complications, related to the propofol-based sedation. We further performed a sensitivity test with 1-to-5 propensity score matching analysis to assess the robustness of our findings. Among 2569 children, 3.9% experienced respiratory problems related to the sedation. After 1-to-5 propensity matching analysis, cardiac and neurologic comorbidities, crying before sedation, a history of snoring or upper respiratory infection, and prolonged duration of sedation were independently associated with the occurrence of adverse respiratory events. Conclusions : Our protocol for pediatric sedation demonstrates a high success rate and low likelihood of fatal complications, but proactive management prior to propofol-based sedation is critical to prevent adverse respiratory events in children. What is Known: • Propofol-based pediatric sedation is associated with adverse events necessarily even though performed by professional anesthesiologists solely. What is New: • Cardiac and neurologic comorbidities, crying before sedation, a history of snoring or upper respiratory infection, and prolonged duration of sedation were independently associated with the occurrence of respiratory adverse events. • Proactive management prior to sedation is critical to preventing adverse respiratory events for pediatrics.