Resumo

LAPERE, C; GRAY, R  e  WILSON, G. Paediatric out-of-theatre procedural sedation at a tertiary children's hospital: A prospective observational study. S. Afr. j. child health [online]. 2021, vol.15, n.1, pp.33-37. ISSN 1999-7671.  http://dx.doi.org/10.7196/sajch.2020.v15i1.1775.

BACKGROUND: Red Cross War Memorial Childrens Hospital (RCWMCH) is one of the largest paediatric hospitals in Africa. Despite an increasing number of surgical and diagnostic procedures being performed annually, a formal out-of-theatre sedation service does not exist. Procedural sedation and analgesia (PSA) is an important adjunct in behavioural management for invasive procedures in childrenOBJECTIVE: A prospective, observational study was performed at RCWMCH, aimed primarily at defining the number of cases of PSA performed outside the operating theatreMETHODS: Data were collected over a period of 3 months from all procedural out-of-theatre sedations performed, including ward patients and outpatient departments. All children <13 years of age were includedRESULTS: A total of 639 sedations were performed. Of these sedations, 288 (45.1%) paper responses were captured and analysed. The reported incidence of airway obstruction was 4.9% (n=14/288), desaturation 4.2% (n=12/288), laryngospasm 0.3% (n=1/288) and nausea and vomiting 2.4% (n=7/288). Three cases required conversion to general anaesthesia, and four cases were abandoned as a result of inadequate sedation. In 16.3% (n=47/288) of cases, the clinician was an operator sedationist (the same person performing the sedation and the procedure). In 90.6% of cases, the intravenous route was utilised, with dexmedetomidine, ketamine and propofol being the three most commonly used agentsCONCLUSION: A total of 639 PSA events were recorded in 3 months. The 288 events analysed were safely performed with minimal serious reported events. These results compare favourably with international studies and provide quantitative evidence as a prelude to setting up a dedicated sedation service at RCWMCH

        · texto em Inglês     · Inglês ( pdf )