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Comparison of different anesthesia techniques during esophagogastroduedenoscopy in children: a randomized trial
Author(s) -
Patino Mario,
Glynn Susan,
Soberano Mark,
Putnam Philip,
Hossain Md Monir,
Hoffmann Clifford,
Samuels Paul,
Kibelbek Michael J.,
Gunter Joel
Publication year - 2015
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/pan.12717
Subject(s) - medicine , laryngospasm , anesthesia , propofol , perioperative , apnea , randomization , anesthetic , randomized controlled trial , sevoflurane , incidence (geometry) , airway , surgery , physics , optics
Summary Background 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. Aims To evaluate the incidence of respiratory complications (primary aim) and institutional efficiency (secondary aim) among three different anesthetic techniques in children undergoing EGD . Methods 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 2 between 94% and 85%), severe desaturation (SpO 2 < 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). Results One hundred and seventy‐nine children aged 1–12 years (median 7 years; 4.0, 10.0) were enrolled (Group IS N = 60, Group IP N = 59, Group NA N = 61). The incidence of respiratory complications was higher in the Group NA (0.459) vs Group IS (0.033) or Group IP (0.086) ( P < 0.0001). The most commonly observed complications were desaturation, inadequate anesthesia, and apnea. There were no differences in institutional efficiency among the three groups. Conclusion 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.