Anesthesia and sedation in pediatric gastrointestinal endoscopic procedures: A review

作     者：Abdul Q Dar Zahoor A Shah 

作者机构：Anesthesiology and Critical CareSheri Kashmir Institute of Medical SciencesSrinagarKashmir 190011India 

出 版 物：《World Journal of Gastrointestinal Endoscopy》 (世界胃肠内镜杂志（英文版）（电子版）)

年 卷 期：2010年第2卷第7期

页      面：257-262页

学科分类：1002[医学-临床医学] 100202[医学-儿科学] 10[医学] 

主　　题：Gastrointestinal Endoscopy Pediatrics Sedation General anesthesia 

摘      要：Gastrointestinal(GI) endoscopic procedure has become an essential modality for evaluation and treatment of GI diseases.Intravenous(IV) sedation and General Anesthesia(GA) have both been employed to minimize discomfort and provide amnesia.Both these procedures require,at the very least,monitoring of the level of consciousness,pulmonary ventilation,oxygenation and hemodynamics.Although GI endoscopy is considered safe,the procedure has a potential for complications.Increased awareness of the complications associated with sedation during GI endoscopy in children,and involving the anesthesiologists in caring for these children,may be optimal for safety.Belonging to a younger age group,having a higher ASA class and undergoing IV sedation were identified as risk factors for developing complications.Reported adverse events included inadequate sedation,low oxygen saturation,airway obstruction,apnea needing bag mask ventilation,excitement and agitation,hemorrhage and perforation.A complication rate of 1.2% was associated with procedures performed under GA,as compared to 3.7% of complications associated with IV sedation.IV sedation was seen to be independently associated with a cardiopulmonary complication rate 5.3% times higher when compared to GA.GA can therefore be considered safer and more effective in providing comfort and amnesia.