title: Efficacy, safety, and cost of intravenous sedation versus general anesthesia in children undergoing endoscopic procedures.
abstract: 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.
authors.affiliation: Division of Gastroenterology and Nutrition, University of Texas Southwestern Medical Center at Dallas 75235-9063, USA.
authors.forename: R H
authors.initials: RH
authors.lastname: Squires
authors.forename: F
authors.initials: F
authors.lastname: Morriss
authors.forename: S
authors.initials: S
authors.lastname: Schluterman
authors.forename: B
authors.initials: B
authors.lastname: Drews
authors.forename: L
authors.initials: L
authors.lastname: Galyen
authors.forename: K O
authors.initials: KO
authors.lastname: Brown
mesh_terms: 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
chemical_list: D008614:Meperidine; D008874:Midazolam