Efficacy, safety, and cost of intravenous sedation versus general anesthesia in children undergoing endoscopic procedures.
We prospectively evaluated 226 patients under 18 years of age who underwent 296 procedures, and intravenous sedation and general anesthesia were compared in regard to efficacy, safety, and cost. Children 6 to 9 years of age required the highest doses of midazolam (0.14 +/- 0.04 mg/kg) and meperidine (2.5 +/- 0.8 mg/kg). A Relative Adequacy Scale, constructed to assess each patient's arousal and cooperation during intravenous sedation, revealed a 95% completion rate. Heart rate monitored before, during, and after the procedure was similar in both groups during the procedure, but a lower preprocedure heart rate was noted in older patients having intravenous sedation, suggesting less patient anxiety. Average charges, excluding endoscopist's and pathology fees, were $768.52 in the intravenous sedation group versus $1,965.42 in the general anesthesia group. Endoscopic procedures can be performed safely, effectively, and at a lower cost to the patient under intravenous sedation in a properly equipped and staffed pediatric endoscopy suite.
Squires
R H
RH
Division of Gastroenterology and Nutrition, University of Texas Southwestern Medical Center at Dallas 75235-9063, USA.
Morriss
F
F
Schluterman
S
S
Drews
B
B
Galyen
L
L
Brown
K O
KO
D000293:Adolescent; D000768:Anesthesia, General / Q000009:adverse effects / Q000191:economics; D001143:Arousal; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation / Q000009:adverse effects / Q000191:economics; D003365:Costs and Cost Analysis; D016145:Endoscopy, Digestive System / Q000191:economics; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007223:Infant; D008614:Meperidine / Q000008:administration & dosage; D008874:Midazolam / Q000008:administration & dosage; D011446:Prospective Studies
D008614:Meperidine; D008874:Midazolam