Document Detail


The 'dark' side of sedation: 12 years of office-based pediatric deep sedation for electroretinography in the dark.
MedLine Citation:
PMID:  21155929     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Analyze pediatric ERG data for adverse events, interventions, and outcomes of propofol sedations performed in near-complete darkness.
AIM: 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 AND MATERIALS: 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:
Kirk Lalwani; Brian D Tompkins; Kevin Burnes; Melissa R Krahmer; Mark E Pennesi; Richard G Weleber
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Paediatric anaesthesia     Volume:  21     ISSN:  1460-9592     ISO Abbreviation:  Paediatr Anaesth     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-15     Completed Date:  2011-03-31     Revised Date:  2012-07-03    
Medline Journal Info:
Nlm Unique ID:  9206575     Medline TA:  Paediatr Anaesth     Country:  France    
Other Details:
Languages:  eng     Pagination:  65-71     Citation Subset:  IM    
Copyright Information:
© 2010 Blackwell Publishing Ltd.
Affiliation:
Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Doernbecher Children's Hospital, Portland, OR 97239, USA. lalwanik@ohsu.edu
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MeSH Terms
Descriptor/Qualifier:
Airway Management
Anesthesia Recovery Period
Child
Child, Preschool
Darkness
Deep Sedation* / adverse effects
Electroretinography / methods*
Female
Humans
Hypnotics and Sedatives / administration & dosage,  adverse effects
Infant
Infusions, Intravenous
Male
Patient Discharge
Propofol / administration & dosage,  adverse effects
Prospective Studies
Retinal Rod Photoreceptor Cells / physiology
Vision Disorders / diagnosis
Chemical
Reg. No./Substance:
0/Hypnotics and Sedatives; 2078-54-8/Propofol
Comments/Corrections
Comment In:
Paediatr Anaesth. 2012 Jun;22(6):582-3   [PMID:  22594412 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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