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Prolonged Anesthetic Exposure in Children and Factors Associated With Exposure Duration

Caleb Ing1, Xiaoyue Ma2, Anna J Klausner2

  • 1Departments of Anesthesiology and Epidemiology, Columbia University College of Physicians and Surgeons and Mailman School of Public Health.

Journal of Neurosurgical Anesthesiology
|February 16, 2019
PubMed

Insights

Most pediatric anesthesia lasts under an hour, but prolonged anesthesia over 3 hours affects 7% of cases. Infants and sicker patients face longer anesthetic durations, impacting operating room scheduling.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Health Services Research

Background:

  • Anesthetic exposure duration is under scrutiny due to FDA warnings against prolonged use in children (>3 hours).
  • Understanding factors influencing anesthetic duration is crucial for pediatric patient safety.

Purpose of the Study:

  • To describe anesthetic duration in pediatric patients.
  • To determine the prevalence of prolonged anesthetic exposures (>3 hours).
  • To identify patient and hospital factors associated with longer anesthetic durations.

Main Methods:

  • Analysis of 2,613,344 pediatric anesthetic records (2010-2015) from the American Society of Anesthesiologist's National Anesthesia Clinical Outcomes Registry.
  • Independent assessment of common pediatric inpatient procedures to identify factors associated with exposure duration.
  • Poisson regression modeling to adjust for procedure type and analyze influencing factors.

Main Results:

  • The mean pediatric anesthetic duration was 83.3 minutes (median, 57 minutes).
  • Prolonged exposures (>3 hours) accounted for 7% of records (15% in infants).
  • Infants (ADR 1.205), ASA 4 patients (ADR 1.381), and university hospitals (ADR 1.241) experienced significantly longer anesthetic durations.

Conclusions:

  • While most pediatric anesthetics are brief, a notable percentage exceed 3 hours.
  • Anesthetic duration in pediatric inpatient procedures is linked to patient (e.g., ASA status, age) and hospital (e.g., type) characteristics.
  • Identifying at-risk children can inform procedure time prediction and optimize operating room scheduling.
Abstract

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