Colonoscopy under general anesthesia in children.
OBJECTIVE
In children, colonoscopy is usually performed using deep sedation that may be associated with significant risks. The purpose of this study was to evaluate the safety of colonoscopy performed under general anesthesia.


METHODS
All patients undergoing colonoscopy during a 3-year period were reviewed for the study. One hundred and thirty-six procedures were performed. Colonoscopies were performed by a pediatric gastroenterologist. Anesthesia was administered by a pediatric anesthetist in a gastroenterology procedure room, adjacent to the operating recovery area.


RESULTS
Three patients had significant abdominal pain and tenderness after the procedure, 1 of whom suffered a perforation of the sigmoid colon. This patient had severe ulcerative colitis. The gastrointestinal complication rate was no higher than reported in adult patients undergoing colonoscopy under sedation. No significant complications relating to the administration of anesthesia were encountered.


CONCLUSIONS
We conclude that colonoscopy performed under general anesthesia in children is a very safe procedure. It is superior to the use of sedation because the child is not placed at risk of respiratory compromise. Furthermore, the procedure is less worrisome for children when performed under a general anesthetic.
Department of Paediatrics, University College Dublin and the Children's Research Centre, Our Lady's Hospital for Sick Children, Crumlin, Dublin, Ireland.
M
M
Dillon
S
S
Brown
W
W
Casey
D
D
Walsh
M
M
Durnin
K
K
Abubaker
B
B
Drumm
D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000768:Anesthesia, General; D002648:Child; D002675:Child, Preschool; D012809:Colon, Sigmoid / Q000293:injuries; D003113:Colonoscopy; D005260:Female; D006801:Humans; D007223:Infant; D007416:Intestinal Perforation / Q000209:etiology; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D012307:Risk Factors