title: Postdischarge adverse events related to sedation for diagnostic imaging in children.
abstract: OBJECTIVE
  The objectives of this study were to describe the type and frequency of postdischarge adverse events related to sedation for elective diagnostic imaging in children and to determine if any patient or drug characteristics were associated with such adverse events.
  
  
  METHODS
  We conducted a prospective observational study of children younger than 18 years who underwent sedation for elective magnetic resonance imaging at a tertiary care hospital. We administered a postdischarge adverse event questionnaire to families within 3 to 5 days after sedation to assess adverse events such as behavioral changes, vomiting, recovery time to baseline status, and need for medical follow-up.
  
  
  RESULTS
  We enrolled 322 patients, of which 253 (78.5%) completed phone follow-up. The majority of study patients were male (58.1%) and belonged to American Society of Anesthesiologists category 2 (52.2%). A combination of pentobarbital and midazolam (53.4%) was the most commonly used sedation medication; 64.4% patients experienced postdischarge adverse events. The most common postdischarge adverse event reported were incoordination of movements (53.8%), dizziness (31.2%), and agitation (19.8%); 48.6% of patients required more than 9 hours to return to baseline behavior. No patient required evaluation at a medical facility for these postdischarge adverse events. Logistic regression analysis showed that use of pentobarbital and adverse event during sedation were significantly associated with postdischarge adverse events.
  
  
  CONCLUSIONS
  Postdischarge adverse events related to sedation for diagnostic imaging are minor, mostly behavioral, but occur in a significant number of patients. Parents should be provided with detailed discharge instructions to anticipate such adverse events at home.
authors.affiliation: Department of Pediatric Emergency Medicine, Children's Hospital of Michigan, Detroit, MI 48201, USA. drrahulkaila@gmail.com
authors.forename: Rahul
authors.initials: R
authors.lastname: Kaila
authors.forename: Xinguang
authors.initials: X
authors.lastname: Chen
authors.forename: Nirupama
authors.initials: N
authors.lastname: Kannikeswaran
mesh_terms: D002648:Child; D002675:Child, Preschool; D004244:Dizziness / Q000139:chemically induced; D005260:Female; D005283:Fentanyl / Q000009:adverse effects; D005500:Follow-Up Studies; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects*; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008874:Midazolam / Q000009:adverse effects; D009069:Movement Disorders / Q000209:etiology; D010351:Patient Discharge; D010424:Pentobarbital / Q000009:adverse effects; D011446:Prospective Studies; D011595:Psychomotor Agitation / Q000209:etiology
chemical_list: D006993:Hypnotics and Sedatives; D010424:Pentobarbital; D008874:Midazolam; D005283:Fentanyl