Comparison of different anesthesia techniques during esophagogastroduedenoscopy in children: a randomized trial. Issue 10 (17th July 2015)

• Record Type: Journal Article
• Authors: Patino, Mario; Glynn, Susan; Soberano, Mark; Putnam, Philip; Hossain, Md Monir; Hoffmann, Clifford; Samuels, Paul; Kibelbek, Michael J.; Gunter, Joel; Cravero, Joseph
• Is Part Of: Paediatric anaesthesia. Volume 25:Issue 10(2015)
• Page Start: 1013
• Page End: 1019
• Publication Date: 2015-07-17
• Subjects: Pediatric anesthesia -- Periodicals; 617.96798
• DOI: 10.1111/pan.12717
• Languages: English
• ISSNs: 1155-5645

Abstract

<abstract abstract-type="main" id="pan12717-abs-0001"> <title>Summary</title> <sec id="pan12717-sec-0001" sec-type="section"> <title>Background</title> <p>Esophagogastroduedenoscopy (EGD) in children is usually performed under general anesthesia. Anesthetic goals include minimization of airway complications while maximizing operating room (OR) efficiency. Currently, there is no consensus on which anesthetic technique best meets these goals. We performed a prospective randomized study comparing three different anesthetic techniques.</p> </sec> <sec id="pan12717-sec-0002" sec-type="section"> <title>Aims</title> <p>To evaluate the incidence of respiratory complications (primary aim) and institutional efficiency (secondary aim) among three different anesthetic techniques in children undergoing EGD.</p> </sec> <sec id="pan12717-sec-0003" sec-type="section"> <title>Methods</title> <p>Subjects received a standardized inhalation induction of anesthesia followed by randomization to one of the three groups: Group intubated, sevoflurane (IS), Group intubated, propofol (IP), and Group native airway, nonintubated, propofol (NA). Respiratory complications included minor desaturation (SpO<sub>2</sub> between 94% and 85%), severe desaturation (SpO<sub>2</sub> < 85%), apnea, airway obstruction/laryngospasm, aspiration, and/or inadequate anesthesia during the endoscopy. Evaluation of institutional efficiency was determined by examining the time spent during the different phases of care (anesthesia preparation, procedure, OR stay, recovery, and total perioperative care).</p> </sec> <sec id="pan12717-sec-0004" sec-type="section"> <title>Results</title> <p>One hundred and seventy‐nine children aged 1–12 years (median 7 years; 4.0, 10.0) were enrolled (Group IS <italic>N</italic> = 60, Group IP <italic>N</italic> = 59, Group NA <italic>N</italic> = 61). The incidence of respiratory complications was higher in the Group NA (0.459) vs Group IS (0.033) or Group IP (0.086) (<italic>P </italic><<italic> </italic>0.0001). The most commonly observed complications were desaturation, inadequate anesthesia, and apnea. There were no differences in institutional efficiency among the three groups.</p> </sec> <sec id="pan12717-sec-0005" sec-type="section"> <title>Conclusion</title> <p>Respiratory complications were more common in Group NA. The use of native airway with propofol maintenance during EGD does not offer advantages with respect to respiratory complications or institutional efficiency.</p> </sec> </abstract>