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Effects of anxiety on sedation among pediatric patients undergoing esophagogastroduodenoscopy

You Jin Choi1,2, Eun Jin Park3, Yoo Min Lee4,5

  • 1Department of Pediatrics, 119750Inje University Ilsan Paik Hospital, Republic of Korea.

Clinical Child Psychology and Psychiatry
|April 22, 2022
PubMed

Insights

High anxiety in children undergoing endoscopy can impact sedation. Increased anxiety, particularly in 6-12-year-olds and those showing irritability, often requires higher sedative doses for esophagogastroduodenoscopy (EGD).

Area of Science:

  • Pediatric Gastroenterology
  • Anesthesiology
  • Child Psychology

Background:

  • Anxiety is common in children undergoing medical procedures.
  • The impact of pre-procedural anxiety on sedation effectiveness during pediatric endoscopy is not fully understood.

Purpose of the Study:

  • To investigate the relationship between anxiety severity and sedation requirements in children undergoing esophagogastroduodenoscopy (EGD).

Main Methods:

  • Prospective recruitment of pediatric patients (<18 years) scheduled for EGD.
  • Anxiety assessment using the Spence Children's Anxiety Scale (SCAS).
  • Analysis of sedative drug type and dose, sedation depth, and complications correlated with SCAS scores.

Main Results:

  • Children aged 6-12 years and those exhibiting irritability showed significantly higher SCAS scores.
  • Irritability was associated with higher anxiety levels across multiple SCAS subscales.
  • Children exhibiting irritability were more likely to require higher midazolam doses (p = 0.006).
  • No significant association found between SCAS scores and other sedation complications or total sleep time.

Conclusions:

  • Elevated anxiety levels in pediatric patients, especially those aged 6-12 and exhibiting irritability, are linked to challenges in achieving adequate sedation during EGD.
  • Higher sedative doses or more potent agents may be necessary for effective EGD in children with heightened anxiety.
  • Anxiety management strategies could improve sedation efficacy and patient experience during pediatric endoscopy.

Keywords:
Endoscopyanesthesiaanxietypediatric patients

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