Pediatric anesthesia in the nonoperating room setting.

PURPOSE OF REVIEW

The paper will review the few studies that have been published recently on nonoperating room pediatric anesthesia/sedation. These studies target gaps in our understanding of critical factors associated with the provision of nonoperating room anesthesia safety and reliability in children.

RECENT FINDINGS

More objective data regarding the safety and reliability of this practice have become available. Video can accurately capture a child's state and allow comparison of different sedation techniques more objectively than is possible with available literature. The use of standard simulated events allows rescue performance in actual care systems to be tested for their ability to manage a rare, but critical respiratory depression episode. Preliminary findings from a large multicenter study from the Pediatric Procedural Sedation Research Consortium suggests critical adverse events are rare (one cardiac arrest in over 30,000 sedation encounters), but that potentially critical events occur commonly (one in 400 procedures was associated with stridor, laryngospasm, wheezing or apnea).

SUMMARY

Research into the critical factors that impact safety and reliability in the performance of nonoperating room anesthesia for children is providing objective observational techniques along with large outcomes databases that should enable targeted improvements in the safety and reliability of this growing practice.