Trends in Outpatient Procedural Sedation: 2007-2018

Area of Science:

• Pediatric Medicine
• Anesthesiology
• Health Services Research

Background:

• Pediatric subspecialists frequently administer procedural sedation outside the operating room.
• Large-scale studies on outpatient pediatric procedural sedation trends are limited.
• The Pediatric Sedation Research Consortium database provides valuable data for trend analysis.

Purpose of the Study:

• To identify significant trends in outpatient pediatric procedural sedation.
• To analyze changes in provider types, medications, and patient characteristics over time.

Main Methods:

• Utilized prospectively collected data from 2007 to 2018 from the Pediatric Sedation Research Consortium.
• Employed the Cochran-Armitage test for trend to assess associations between year and sedation characteristics.
• Analyzed patient demographics, sedation medications, provider types, and adverse events across three 4-year epochs.

Main Results:

• Over 432,000 sedation encounters were analyzed, revealing a decrease in sedation for infants under 3 months.
• A significant rise in pediatric hospitalists providing procedural sedation was observed (0.6% to 9.5%).
• Trends showed increased dexmedetomidine use and decreased use of chloral hydrate and pentobarbital; serious adverse events saw a non-significant increase.

Conclusions:

• Outpatient pediatric procedural sedation has seen a shift towards pediatric hospitalists administering care.
• There has been a notable decrease in the utilization of chloral hydrate and pentobarbital for pediatric sedation.
• Further investigation is warranted to determine if these sedation service trends impact healthcare costs and resource optimization.