Pediatr Gastroenterol Hepatol Nutr.  2014 Mar;17(1):6-12.

Sedation for Pediatric Endoscopy

Affiliations
  • 1Department of Pediatrics, Maryknoll Medical Center, Busan, Korea. id2072@naver.com

Abstract

It is more difficult to achieve cooperation when conducting endoscopy in pediatric patients than adults. As a result, the sedation for a comfortable procedure is more important in pediatric patients. The sedation, however, often involves risks and side effects, and their prediction and prevention should be sought in advance. Physicians should familiarize themselves to the relevant guidelines in order to make appropriate decisions and actions regarding the preparation of the sedation, patient monitoring during endoscopy, patient recovery, and hospital discharge. Furthermore, they have to understand the characteristics of the pediatric patients and different types of endoscopy. The purpose of this article is to discuss the details of sedation in pediatric endoscopy.

Keyword

Sedation; Endoscopy; Pediatric

MeSH Terms

Adult
Endoscopy*
Humans
Monitoring, Physiologic

Reference

1. American Academy of Pediatrics. American Academy of Pediatric Dentistry. Coté CJ, Wilson S. Work Group on Sedation. Guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures: an update. Pediatrics. 2006; 118:2587–2602.
Article
2. American Society of Anesthesiologists Task Force on Sedation and Analgesia by Non-Anesthesiologists. Practice guidelines for sedation and analgesia by non-anesthesiologists. Anesthesiology. 2002; 96:1004–1017.
3. Fox V. Upper gastrointestinal endoscopy. In : Walker WA, Durie PR, Hamilton JR, Walker-Smith JA, Watkins JB, editors. Pediatric gastrointestinal disease: pathophysiology, diagnosis, management. St. Louis: Mosby;2000. p. 1514–1532.
4. Liacouras CA, Mascarenhas M, Poon C, Wenner WJ. Placebo-controlled trial assessing the use of oral midazolam as a premedication to conscious sedation for pediatric endoscopy. Gastrointest Endosc. 1998; 47:455–460.
Article
5. Squires RH Jr, Morriss F, Schluterman S, Drews B, Galyen L, Brown KO. Efficacy, safety, and cost of intravenous sedation versus general anesthesia in children undergoing endoscopic procedures. Gastrointest Endosc. 1995; 41:99–104.
Article
6. Lightdale JR. Sedation for pediatric endoscopy. Tech Gastrointest Endosc. 2013; 15:3–8.
Article
7. Sidi A, Lobato EB, Cohen JA. The American Society of Anesthesiologists' Physical Status: category V revisited. J Clin Anesth. 2000; 12:328–334.
Article
8. Samsoon GL, Young JR. Difficult tracheal intubation: a retrospective study. Anaesthesia. 1987; 42:487–490.
Article
9. Peter G, Michael DR. Medications. In : Kliegmen RM, Behrman RE, Jenson HB, Stanton BF, editors. Nelson textbook of pediatrics. 18th ed. Philadelphia: Saunders Elsevier;2007. p. 2955–2999.
10. Taketomo CK, Hodding JH, Karus DM. Pediatric dosage handbook: including neonatal dosing, drug administration & extemporaneous preparations, 2004-2005. 11th ed. Hudson, Ohio: Lexi-Comp Inc.;2004. p. 997–1000.
11. Massanari M, Novitsky J, Reinstein LJ. Paradoxical reactions in children associated with midazolam use during endoscopy. Clin Pediatr (Phila). 1997; 36:681–684.
Article
12. Tolia V, Brennan S, Aravind MK, Kauffman RE. Pharmacokinetic and pharmacodynamic study of midazolam in children during esophagogastroduodenoscopy. J Pediatr. 1991; 119:467–471.
Article
13. Salonen M, Kanto J, Iisalo E, Himberg JJ. Midazolam as an induction agent in children: a pharmacokinetic and clinical study. Anesth Analg. 1987; 66:625–628.
14. Jacobsen J, Flachs H, Dich-Nielsen JO, Rosen J, Larsen AB, Hvidberg EF. Comparative plasma concentration profiles after i.v., i.m. and rectal administration of pethidine in children. Br J Anaesth. 1988; 60:623–626.
Article
15. Yaster M, Nichols DG, Deshpande JK, Wetzel RC. Midazolam-fentanyl intravenous sedation in children: case report of respiratory arrest. Pediatrics. 1990; 86:463–467.
Article
16. Krauss B, Green SM. Sedation and analgesia for procedures in children. N Engl J Med. 2000; 342:938–945.
Article
17. Coté CJ, Karl HW, Notterman DA, Weinberg JA, McCloskey C. Adverse sedation events in pediatrics: analysis of medications used for sedation. Pediatrics. 2000; 106:633–644.
18. Malviya S, Voepel-Lewis T, Tait AR. Adverse events and risk factors associated with the sedation of children by nonanesthesiologists. Anesth Analg. 1997; 85:1207–1213.
Article
19. Arandia HY, Patil VU. Glottic closure following large doses of fentanyl. Anesthesiology. 1987; 66:574–575.
Article
20. Balsells F, Wyllie R, Kay M, Steffen R. Use of conscious sedation for lower and upper gastrointestinal endoscopic examinations in children, adolescents, and young adults: a twelve-year review. Gastrointest Endosc. 1997; 45:375–380.
Article
21. Koehntop DE, Rodman JH, Brundage DM, Hegland MG, Buckley JJ. Pharmacokinetics of fentanyl in neonates. Anesth Analg. 1986; 65:227–232.
Article
22. Motamed F, Aminpour Y, Hashemian H, Soltani AE, Najafi M, Farahmand F. Midazolam-ketamine combination for moderate sedation in upper GI endoscopy. J Pediatr Gastroenterol Nutr. 2012; 54:422–426.
Article
23. Green SM, Nakamura R, Johnson NE. Ketamine sedation for pediatric procedures: Part 1, A prospective series. Ann Emerg Med. 1990; 19:1024–1032.
Article
24. Schüttler J, Ihmsen H. Population pharmacokinetics of propofol: a multicenter study. Anesthesiology. 2000; 92:727–738.
25. Eyres R. Update on TIVA. Paediatr Anaesth. 2004; 14:374–379.
Article
26. Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy. Lichtenstein DR, Jagannath S, Baron TH, Anderson MA, Banerjee S, et al. Sedation and anesthesia in GI endoscopy. Gastrointest Endosc. 2008; 68:815–826.
Article
27. Benson AA, Cohen LB, Waye JD, Akhavan A, Aisenberg J. Endoscopic sedation in developing and developed countries. Gut Liver. 2008; 2:105–112.
Article
28. Cohen LB, Wecsler JS, Gaetano JN, Benson AA, Miller KM, Durkalski V, et al. Endoscopic sedation in the United States: results from a nationwide survey. Am J Gastroenterol. 2006; 101:967–974.
Article
29. Chen PH, Wu TC, Chiu CY. Pediatric gastrointestinal endoscopic sedation: a 2010 nationwide survey in Taiwan. Pediatr Neonatol. 2012; 53:188–192.
Article
30. Ryoo E, Kim KM. Scientific Committee of the Korean Society of Pediatric Gastroenterology, Hepatology, and Nutrition. Pediatric endoscopic sedation in korea: a survey of the Korean society of pediatric gastroenterology, hepatology and nutrition. Korean J Pediatr Gastroenterol Nutr. 2008; 11:21–27.
Article
31. van Beek EJ, Leroy PL. Safe and effective procedural sedation for gastrointestinal endoscopy in children. J Pediatr Gastroenterol Nutr. 2012; 54:171–185.
Article
32. Lightdale JR, Valim C, Newburg AR, Mahoney LB, Zgleszewski S, Fox VL. Efficiency of propofol versus midazolam and fentanyl sedation at a pediatric teaching hospital: a prospective study. Gastrointest Endosc. 2008; 67:1067–1075.
Article
33. Abu-Shahwan I, Mack D. Propofol and remifentanil for deep sedation in children undergoing gastrointestinal endoscopy. Paediatr Anaesth. 2007; 17:460–463.
Article
34. Vargo JJ, Zuccaro G Jr, Dumot JA, Conwell DL, Morrow JB, Shay SS. Automated graphic assessment of respiratory activity is superior to pulse oximetry and visual assessment for the detection of early respiratory depression during therapeutic upper endoscopy. Gastrointest Endosc. 2002; 55:826–831.
Article
35. Lightdale JR, Sethna NF, Heard LA, Donovan KM, Fox VL. A pilot study of end-tidal carbon dioxide monitoring using microstream capnography in children undergoing endoscopy with conscious sedation. Gastrointest Endosc. 2002; 55:AB144–AB146.
36. Aldrete JA. The post-anesthesia recovery score revisited. J Clin Anesth. 1995; 7:89–91.
Article
37. Miller RD. Miller's anesthesia. 6th ed. Philadelphia: Saunders Elsevier;2005. p. 2708–2709.
Full Text Links
  • PGHN
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr