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논문 기본 정보

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학술저널
저자정보
Yang Sung Min (Department of Pediatrics Chung-Ang University Hospital Seoul Korea.) 이대용 (중앙대학교) Choi Geun Joo (Department of Anesthesiology Chung-Ang University Hospital Chung-Ang University College of Medicine) 임인석 (중앙대학교) 채수안 (중앙대학교) 윤신원 (중앙대학교) 이나미 (중앙대학교) Kim Su Yeong (Department of Pediatrics Chung-Ang University Hospital Seoul Korea.) 최응상 (Hanil General Hospital)
저널정보
대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.35 No.21
발행연도
2020.1
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1 - 11 (11page)

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Background: Endoscopy is used for diagnosing and treating various digestive diseases in children as well as in adults. However, in pediatric patients, it is recommended that sufficient sedation should be ensured before conducting endoscopy, since insufficient sedation may cause serious complications. However, in Korea, no studies have yet described the types of sedation drugs, effects of sedation, and efficiency of endoscopy with respect to the sedation instructor. Thus, we investigated the effectiveness of sedative procedures performed by anesthesiologists. Methods: We retrospectively reviewed the medical records of patients aged < 18 years who underwent endoscopy during March 2014–July 2019. Data of sedation instructors, sedation drugs and their doses, complications, and the recovery after sedation were evaluated. Results: Of 257 patients, 217 underwent esophagogastroduodenoscopy (EGD) and 40 underwent colonoscopies. Before EGD, 29 patients (13.4%) underwent sedation by the pediatric endoscopist and 188 (86.6%) were sedated by the anesthesiologist. The anesthesiologist performed the sedation for all 40 patients who underwent colonoscopy. Endoscopic examinations performed by the anesthesiologist were relatively more time- consuming (401.0 ± 135.1 seconds vs. 274.9 ± 106.1 seconds, P < 0.001). We observed that in patients who underwent EGD, there was a difference in the dose of midazolam administered (P = 0.000). When comparing EGD and colonoscopy in patients undergoing sedation by the anesthesiologist, there were no significant differences in the doses of midazolam and ketamine, but the dose of propofol increased for colonoscopy (2.50 ± 0.95 mg/kg vs. 4.71 ± 1.66 mg/kg, P = 0.000). The cognitive recovery time according to drug dose was associated with propofol only in EGD with a shorter endoscopy time. The longer cognitive recovery time in colonoscopy and the discharge time of EGD and colonoscopies were not associated with propofol use. Conclusion: When sedation is performed by an anesthesiologist, various drugs are used with sufficient doses and complications are reduced, but the discharge time does not change. For performing pediatric endoscopy in Korea, anesthesiologists should be considered for inducing anesthesia.
#Endoscopy #Pediatric Patients #Anesthesia #Propofol

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참고문헌 (39)

참고문헌 신청
Thomson M / 2017 / Paediatric gastrointestinal endoscopy : European Society for Paediatric Gastroenterology Hepatology and Nutrition and European Society of Gastrointestinal Endoscopy Guidelines / J Pediatr Gastroenterol Nutr 64(1):133~153 google schola Wyllie R / 1993 / Gastrointestinal endoscopy in infants and children / Pediatr Rev 14(9):352~359 google schola Pall H / 2016 / Developing the pediatric gastrointestinal endoscopy unit : a clinical report by the endoscopy and procedures committee / J Pediatr Gastroenterol Nutr 63(2):295~306 google schola Isik IA / 2015 / sedation practice outside the operating room for pediatric gastrointestinal endoscopy / Indian Pediatr 52(11):989~990 google schola Coté CJ / 2019 / Guidelines for monitoring and management of pediatric patients before, during, and after sedation for diagnostic and therapeutic procedures / Pediatrics 143(6):e20191000 google schola

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