title: The 'dark' side of sedation: 12 years of office-based pediatric deep sedation for electroretinography in the dark.
abstract: OBJECTIVE
  Analyze pediatric ERG data for adverse events, interventions, and outcomes of propofol sedations performed in near-complete darkness.
  
  
  OBJECTIVE
  To demonstrate that deep sedation with propofol for ERG can be performed efficiently and safely in children in near-total darkness.
  
  
  BACKGROUND
  Full-field electroretinography (ERG) is a valuable tool for the diagnosis of vision loss in children. The ERG measures the electrical activity of the retina. In children, ERG quality significantly improves with deep sedation by allowing easier eye electrode placement and decreasing motion artifacts. As this procedure must be performed in darkness, administering sedation imposes unique challenges.
  
  
  METHODS
  ERGs are performed outside of the operating room in our hospital's electrophysiology suite. IVs are placed, and patients are allowed to adapt to complete darkness. An anesthesiologist then administers propofol sedation in the dark with the aid of a red-filter light source and monitor light shields. Data were collected on 379 patients (411 ERGs) performed from 1996 to 2008. These records were reviewed and analyzed for demographic, medical, and anesthetic data.
  
  
  RESULTS
  Propofol sedation resulted in an ERG completion rate of 99.5%. During sedation, 8.5% (35) of patients experienced minor respiratory complications such as airway obstruction that resulted in an oxygen saturation <90%. A total of 9.7% (40) of patients required minor airway interventions such as a chin lift.
  
  
  CONCLUSIONS
  We demonstrated that pediatric sedation is a safe, efficient, and a cost-effective method for measuring ERGs in a challenging environment. The incidence of minor complications is low and appears similar to other studies of propofol sedation.
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Doernbecher Children's Hospital, Portland, OR 97239, USA. lalwanik@ohsu.edu
authors.forename: Kirk
authors.initials: K
authors.lastname: Lalwani
authors.forename: Brian D
authors.initials: BD
authors.lastname: Tompkins
authors.forename: Kevin
authors.initials: K
authors.lastname: Burnes
authors.forename: Melissa R
authors.initials: MR
authors.lastname: Krahmer
authors.forename: Mark E
authors.initials: ME
authors.lastname: Pennesi
authors.forename: Richard G
authors.initials: RG
authors.lastname: Weleber
mesh_terms: D058109:Airway Management; D000762:Anesthesia Recovery Period; D002648:Child; D002675:Child, Preschool; D003624:Darkness; D054810:Deep Sedation / Q000009:adverse effects; D004596:Electroretinography / Q000379:methods*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects; D007223:Infant; D007262:Infusions, Intravenous; D008297:Male; D010351:Patient Discharge; D015742:Propofol / Q000008:administration & dosage / Q000009:adverse effects; D011446:Prospective Studies; D017948:Retinal Rod Photoreceptor Cells / Q000502:physiology; D014786:Vision Disorders / Q000175:diagnosis
chemical_list: D006993:Hypnotics and Sedatives; D015742:Propofol