Department of Pediatric Cardiology, University Hospital of Saarland, Kirrberger Strasse, Building 9, 66421, Homburg (Saar), Germany.
Department of Gynecology, St. Theresa Hospital Nuremberg, Nuremberg, Germany.
Ital J Pediatr. 2020 Feb 3;46(1):14. doi: 10.1186/s13052-020-0783-y.
As more and more diagnostic and interventional options are becoming available for use in pediatric patients, techniques of procedural sedation analgesia (PSA) are being administered in considerably growing numbers as well.
The objective of this research effort was to conduct the first countrywide survey on the status quo of sedation analgesia as delivered to children and adolescents in Germany.
We dispatched letters to all pediatric hospital settings in Germany (n = 305), including a questionnaire that had been developed with existing guidelines taken into account. Its items were designed to elucidate the current practice of PSA throughout these pediatric centers regarding (a) organizational structures and (b) standards of medication and staffing.
A total of 138 centers returned the questionnaire, hence the response rate was 45.2%. Numerous centers had implemented adequate structures and staffing standards. Deficits were nevertheless identified, most notably in terms of on-location equipment and staff provided to deliver sedations. Essential items of equipment were not provided in up to 26.8% of centers. Adequate staffing was not provided in up to 44.2% of centers, depending on the diagnostic or interventional procedures for which the PSA was delivered. The most widely used sedative agents were midazolam, ketamine/esketamine, and propofol.
Adequate care structures for the management of procedural sedation analgesia have been implemented by many pediatric centers in Germany. On the downside, these findings also reveal deficits that will take efforts to be eliminated.
随着越来越多的诊断和介入选择可用于儿科患者，程序性镇静镇痛 (PSA) 技术的应用也在大幅增加。
本研究旨在对德国儿科患者镇静镇痛的现状进行首次全国性调查。
我们向德国所有儿科医院（n=305）发送了信函，并附有一份根据现有指南制定的问卷。问卷旨在阐明这些儿科中心在 PSA 方面的当前实践，包括 (a) 组织结构和 (b) 药物和人员配备标准。
共有 138 家中心回复了问卷，因此回复率为 45.2%。许多中心已经实施了适当的结构和人员配备标准。但仍存在一些缺陷，尤其是在现场设备和提供镇静的人员方面。多达 26.8%的中心没有配备必要的设备。根据提供 PSA 的诊断或介入程序，多达 44.2%的中心没有配备足够的人员。最广泛使用的镇静剂是咪达唑仑、氯胺酮/右美托咪定和丙泊酚。
德国许多儿科中心已经实施了适当的程序性镇静镇痛管理护理结构。但这些发现也揭示了存在的缺陷，需要努力加以消除。
