Risks of propofol sedation/anesthesia for imaging studies in pediatric research: eight years of experience in a clinical research center.
OBJECTIVE
To quantify the incidence of adverse events associated with anesthesia given for research-driven imaging studies and to identify risk factors for those events in pediatric research subjects.


METHODS
Retrospective cohort study.


METHODS
National Institutes of Health Clinical Center.


METHODS
Children and adolescents enrolled in clinical research protocols who required anesthesia for research-related imaging studies from January 2000 to September 2008.


METHODS
Propofol sedation/anesthesia.


METHODS
The occurrence of respiratory, cardiovascular, and all anesthesia-related adverse events that required intervention while receiving anesthetics for research-driven imaging studies and other noninvasive procedures.


RESULTS
We identified 607 children who received 1480 propofol anesthetic procedures for imaging studies. Seventy percent of anesthetics were given to subjects with severe diseases and significant disabilities (American Society of Anesthesiologists Physical Status [ASA] III). Anesthesia had a mean (SD) duration of 115 (55) minutes, and in 12.5% of procedures, an airway device was necessary. There were 98 notable respiratory, cardiovascular, and other events in 79 anesthetic procedures, a rate of 534 per 10 000 anesthetic procedures with 1 or more adverse events. There was no long-lasting morbidity or mortality. The ASA classification (odds ratio [OR], 2.92; 95% confidence interval [CI], 1.24-6.88), anesthetic effect duration (OR, 1.46; 95% CI, 1.25-1.70), and presence of airway abnormalities (OR, 4.41; 95% CI, 1.60-12.12) were independently associated with adverse events during anesthetic use.


CONCLUSIONS
In our clinical research sample of high-risk children who received sedation/anesthesia by an anesthesiologist, we observed a low incidence of adverse events and no long-term complications. Risk factors for adverse events included higher ASA classification, increasing anesthetic duration, and presence of airway abnormalities.
Pediatrics and Developmental Neuroscience Branch, National Institute of Mental Health, National Institutes of Health Clinical Center, Bethesda, Maryland, USA.
Ruwan
R
Kiringoda
Audrey E
AE
Thurm
Matthew E
ME
Hirschtritt
Deloris
D
Koziol
Robert
R
Wesley
Susan E
SE
Swedo
Naomi P
NP
O'Grady
Zenaide M N
ZM
Quezado
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation / Q000009:adverse effects; D003952:Diagnostic Imaging; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects*; D015994:Incidence; D007223:Infant; D008297:Male; D010372:Pediatrics; D015742:Propofol / Q000009:adverse effects*; D012106:Research; D012189:Retrospective Studies; D012307:Risk Factors
D006993:Hypnotics and Sedatives; D015742:Propofol