Hanson Keith A, Rainey Shane C, Shaikh Nadia, Beekman Michele K
Pediatrics, University of Illinois College of Medicine at Peoria, Peoria, USA.
Child Health, University of Arizona College of Medicine - Phoenix, Phoenix, USA.
Cureus. 2021 Dec 6;13(12):e20207. doi: 10.7759/cureus.20207. eCollection 2021 Dec.
Background Voiding cystourethrography (VCUG) is used to diagnose vesicoureteral reflux (VUR); however, it is an invasive procedure and can be psychologically distressing. Procedural sedation is occasionally utilized to alleviate anxiety during VCUG, and some patient populations may get referred more readily for sedation than others. Sedative medications may also impact the results of the test due to their effects on smooth muscle. The goals of this study were to compare patient characteristics between those that were referred for procedural sedation and those that were not and to compare VCUG results between sedated and non-sedated patients. Methodology We performed a retrospective cohort study of patients aged 2-18 years undergoing VCUG during a five-year period. Sedated patients were matched with non-sedated patients controlling for referring provider and procedure year. Exclusion criteria included chronic catheterization, same-day surgery, current intensive care admission, and sedation restrictions. A total of 284 patients were included. Demographic information, medical comorbidities, and VCUG results were analyzed. Results There were no significant differences between sedated and non-sedated patients in any demographic variables. Neurologic, developmental, and gastrointestinal comorbidities were more common in sedated patients. On multivariate analysis, having more than one comorbid condition was the only significant predictor of referral for procedural sedation. There were no significant differences in VCUG results between sedated and non-sedated patients. Conclusions Patients with comorbidities were more likely to receive procedural sedation for VCUG. Procedural sedation did not have a significant impact on test results, suggesting its potential utility in relieving pain and anxiety associated with VCUG.
排尿性膀胱尿道造影（VCUG）用于诊断膀胱输尿管反流（VUR）；然而，它是一种侵入性检查，可能会给患者带来心理压力。在VCUG检查期间，偶尔会使用程序性镇静来缓解焦虑，某些患者群体可能比其他群体更容易接受镇静。镇静药物也可能因其对平滑肌的作用而影响检查结果。本研究的目的是比较接受程序性镇静和未接受程序性镇静的患者的特征，并比较镇静和未镇静患者的VCUG检查结果。
我们对2至18岁在五年期间接受VCUG检查的患者进行了一项回顾性队列研究。将接受镇静的患者与未接受镇静的患者进行匹配，同时控制转诊医生和检查年份。排除标准包括长期导尿、当日手术、当前入住重症监护病房以及镇静限制。总共纳入了284例患者。分析了人口统计学信息、合并症和VCUG检查结果。
在任何人口统计学变量方面，接受镇静和未接受镇静的患者之间均无显著差异。神经、发育和胃肠道合并症在接受镇静的患者中更为常见。多因素分析显示，患有不止一种合并症是程序性镇静转诊的唯一显著预测因素。镇静和未镇静患者的VCUG检查结果无显著差异。
患有合并症的患者更有可能在VCUG检查时接受程序性镇静。程序性镇静对检查结果没有显著影响，表明其在缓解与VCUG相关的疼痛和焦虑方面具有潜在效用。
