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Author Notes:

Correspondence: Jocelyn R. Grunwell, Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta at Egleston, 1405 Clifton Road NE, Atlanta, GA 30322, USA, jgrunwe@emory.edu

We acknowledge the Emory+Children's Biostatistics Core for help with statistical analysis.

Conflict of interest: Dr. J.R. Grunwell is supported by T32GM095442. Dr. J. Cravero is a section editor of Pediatric Anesthesia.

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Research Funding:

The study received no external funding.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Anesthesiology
  • Pediatrics
  • pediatric
  • procedural sedation
  • adverse events
  • airway obstruction
  • laryngospasm
  • propofol
  • RESEARCH CONSORTIUM
  • OPERATING-ROOM
  • ADVERSE EVENTS
  • PROPOFOL SEDATION
  • THERAPEUTIC PROCEDURES
  • CHILDREN
  • RISK
  • SEDATION/ANESTHESIA
  • EXPERIENCE
  • IMPACT

Outcomes following implementation of a pediatric procedural sedation guide for referral to general anesthesia for magnetic resonance imaging studies

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Journal Title:

Pediatric Anesthesia

Volume:

Volume 26, Number 6

Publisher:

, Pages 628-636

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Background/Aims: Guidelines for referral of children to general anesthesia (GA) to complete MRI studies are lacking. We devised a pediatric procedural sedation guide to determine whether a pediatric procedural sedation guide would decrease serious adverse events and decrease failed sedations requiring rescheduling with GA. Methods: We constructed a consensus-based sedation guide by combining a retrospective review of reasons for referral of children to GA (n = 221) with published risk factors associated with the inability to complete the MRI study with sedation. An interrupted time series analysis of 11 530 local sedation records from the Pediatric Sedation Research Consortium between July 2008 and March 2013, adjusted for case-mix differences in the pre- and postsedation guide cohorts, evaluated whether a sedation guide resulted in decreased severe adverse events (SAE) and failed sedation rates. Results: A significant increase in referrals to GA following implementation of a sedation guide occurred (P < 0.001), and fewer children with an ASA-PS class ≥III were sedated using procedural sedation (P < 0.001). There was no decrease in SAE (P = 0.874) or in SAE plus airway obstruction with concurrent hypoxia (P = 0.435). There was no change in the percentage of failed sedations (P = 0.169). Conclusions: More studies are needed to determine the impact of a sedation guide on pediatric procedural sedation services.

Copyright information:

© 2016 John Wiley & Sons Ltd. This is the peer reviewed version of the following article, which has been published in final form. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.

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