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Incidence of consciousness in pediatric patients during Methotrexate injection with monitored anesthesia care

Y Widyastuti1, M Gentong2, W Astuti3

  • 1Universitas Gadjah Mada, Public Health, and Nursing, Faculty of Medicine, Department of Anesthesia and Intensive Therapy, Jl. Farmako Sekip Utara, Yogyakarta, Indonesia. yunita.widya@ugm.ac.id.

The Medical Journal of Malaysia
|May 31, 2020
PubMed

Insights

Consciousness occurred in 26.5% of pediatric patients during methotrexate injections with Monitored Anesthesia Care (MAC). This high incidence necessitates further prevention strategies for procedural sedation and analgesia.

Area of Science:

  • Anesthesiology
  • Pediatric Medicine

Background:

  • Procedural sedation and analgesia (PSAA) or monitored anesthesia care (MAC) aims to provide analgesia, amnesia, and hypnosis with rapid recovery and minimal side effects.
  • Ensuring adequate sedation depth is crucial for pediatric procedures to manage anxiety, pain, and movement, preventing consciousness and over-sedation.
  • Limited research exists on pediatric patient consciousness during methotrexate injections with MAC.

Purpose of the Study:

  • To determine the incidence of consciousness in pediatric patients undergoing methotrexate injection with Monitored Anesthesia Care (MAC).

Main Methods:

  • An observational study involving 68 pediatric patients (1-18 years) with ASA II physical status.
  • Anesthesia depth was monitored using the Observer's Alertness Assessment Sedation Scale (OAAS) every two minutes.
  • Consciousness was defined as an OAAS score of 5 or observable patient movement.

Main Results:

  • The incidence of positive consciousness was 26.5% at 2 minutes and 3.2% at 4 minutes post-induction.
  • Consciousness was managed with an additional propofol dose of 2mg/kg body weight.

Conclusions:

  • The incidence of pediatric consciousness during methotrexate injections with MAC at Sardjito General Hospital is notably high (26.5% at 2 min, 3.2% at 4 min).
  • These findings indicate a need for enhanced preventive measures for procedural sedation in pediatric patients receiving methotrexate.
Abstract

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