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专业镇静团队对小儿程序性镇痛镇静并发症发生率的影响

The Impact of a Dedicated Sedation Team on the Incidence of Complications in Pediatric Procedural Analgosedation.

作者信息

Apostolidou Sofia, Kintscher Mirna, Schön Gerhard, Ebenebe Chinedu Ulrich, Bartz Hans-Jürgen, Singer Dominique, Zöllner Christian, Röher Katharina

机构信息

Division of Neonatology and Pediatric Intensive Care Medicine, Department of Pediatrics, University Medical Center Hamburg-Eppendorf, D-20246 Hamburg, Germany.

Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, D-20246 Hamburg, Germany.

出版信息

Children (Basel). 2022 Jul 2;9(7):998. doi: 10.3390/children9070998.

Abstract

The number of pediatric procedural sedations for diagnostic and minor therapeutic procedures performed outside the operating room has increased. Therefore, we established a specialized interdisciplinary team of pediatric anesthesiologists and intensivists (Children’s Analgosedation Team, CAST) at our tertiary-care university hospital and retrospectively analyzed the first year after implementation of the CAST. Within one year, 784 procedural sedations were performed by the CAST; 12.2% of the patients were infants <1 year, 41.9% of the patients were classified as American Society of Anesthesiologists (ASA) grade III or IV. Most children received propofol (79%) and, for painful procedures, additional esketamine (48%). Adverse events occurred in 51 patients (6.5%), with a lack of professional experience (OR 0.60; 95% CI 0.42−0.81) and increased propofol dosage (OR 1.33; 95% CI 1.17−1.55) being significant predictors. Overall, the CAST enabled safe and effective procedural sedation in children outside the operating room.

摘要

在手术室以外进行的用于诊断和小型治疗性操作的儿科程序性镇静的数量有所增加。因此,我们在我们的三级大学附属医院成立了一个由儿科麻醉医师和重症监护医师组成的专门跨学科团队(儿童镇痛镇静团队,CAST),并对CAST实施后的第一年进行了回顾性分析。在一年内,CAST进行了784例程序性镇静;12.2%的患者为1岁以下婴儿,41.9%的患者被分类为美国麻醉医师协会(ASA)III或IV级。大多数儿童接受丙泊酚(79%),对于疼痛性操作,额外使用艾司氯胺酮(48%)。51例患者(6.5%)发生不良事件,缺乏专业经验(比值比0.60;95%置信区间0.42 - 0.81)和丙泊酚剂量增加(比值比1.33;95%置信区间1.17 - 1.55)是显著的预测因素。总体而言,CAST能够在手术室以外为儿童提供安全有效的程序性镇静。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f587/9320875/839e80ca296a/children-09-00998-g001.jpg

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