Nong Xiaoling, Lu Yixing, Jiang Wenqing, Qin Yanlv, Jing Shunzhong, Chi Tao, Peng Wei, Liu Siyan, Lin Yunan
Department of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Department of Anesthesiology, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
Front Pediatr. 2024 Dec 16;12:1475891. doi: 10.3389/fped.2024.1475891. eCollection 2024.
The objective of this research was to examine the features and potential hazards of sedation in children of varying ages. Additionally, the study aimed to comprehend these variations to enhance the safety and efficacy of clinical applications.
A retrospective analysis was conducted on case data involving pediatric patients who underwent imaging procedures in outpatient settings and necessitated procedural sedation from 2022 to 2024. The research participants were categorized into three age groups: ≤1 year, 1-3 years, and 3-12 years. The primary sedative agents administered were oral midazolam in conjunction with intranasal dexmedetomidine. We examined the effects of sedation and the occurrence of adverse events across various age groups. Additionally, we applied multivariate logistic regression to identify factors linked to these adverse events.
The study observed 2,194 children, with 879 (40.1%) being ≤1-year-old. The ≤1-year-old group achieved faster sleep onset at 18.7 ± 0.3 min, with no significant variance in awakening time and length of stay among the groups. The incidence of adverse events varied significantly by age, with the highest rate of 12.2% in the ≤1-year-old group and the lowest rate of 9.7% in the 3-12-year-old group. Multivariate analysis revealed age as an independent factor affecting adverse event occurrence, with a relative risk ratio (AOR) of 2.21 (95% CI: 1.31-3.75) for delayed awakening in children ≤1-year-old, 15.03 (95% CI: 1.92-117.61) for hypoglycemia, and a relative risk ratio (AOR) of 4.58 (95% CI: 2.22-9.42) for receiving a significant intervention.
Significant variations in sedation reactions and adverse events were observed across the different age groups. Specifically, children aged ≤1 year exhibited a higher susceptibility to adverse events such as delayed awakening and hypoglycemia.
chictr.org.cn identifier (ChiCTR2400082774).
本研究的目的是检查不同年龄段儿童镇静的特点和潜在危害。此外，该研究旨在了解这些差异，以提高临床应用的安全性和有效性。
对2022年至2024年在门诊接受影像检查并需要进行程序性镇静的儿科患者的病例数据进行回顾性分析。研究参与者分为三个年龄组：≤1岁、1 - 3岁和3 - 12岁。主要使用的镇静剂是口服咪达唑仑联合鼻内右美托咪定。我们检查了不同年龄组的镇静效果和不良事件的发生情况。此外，我们应用多因素逻辑回归来确定与这些不良事件相关的因素。
该研究观察了2194名儿童，其中879名（40.1%）≤1岁。≤1岁组入睡更快，为18.7±0.3分钟，各组间苏醒时间和住院时间无显著差异。不良事件的发生率因年龄而异，≤1岁组最高，为12.2%，3 - 12岁组最低，为9.7%。多因素分析显示年龄是影响不良事件发生的独立因素，≤1岁儿童延迟苏醒的相对风险比（调整后比值比）为2.21（95%可信区间：1.31 - 3.75），低血糖为15.03（95%可信区间：1.92 - 117.61），接受重大干预的相对风险比（调整后比值比）为4.58（95%可信区间：2.22 - 9.42）。
不同年龄组的镇静反应和不良事件存在显著差异。具体而言，≤1岁的儿童对延迟苏醒和低血糖等不良事件的易感性更高。
中国临床试验注册中心标识符（ChiCTR2400082774）。
