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Is Procedural Intravenous Anesthesia Safe for Children? An Analysis of Nationwide Accident Registries in Japan

Megumi Matsumoto1, Eisuke Inage1, Shun Toriumi1

  • 1Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Pediatrics International : Official Journal of the Japan Pediatric Society
|August 3, 2026
PubMed

Insights

Pediatric intravenous anesthesia accidents in Japan are rare but serious, especially in young children with underlying conditions undergoing invasive procedures. Risk stratification and specialist involvement are crucial for patient safety.

Area of Science:

  • Anesthesiology
  • Pediatric Medicine
  • Medical Safety

Background:

  • Pediatric intravenous anesthesia outside operating rooms carries risks like airway obstruction and apnea.
  • The incidence and trends of medical accidents related to pediatric intravenous anesthesia in Japan are not well-documented.
  • The safety of procedural intravenous anesthesia in children requires further investigation.

Purpose of the Study:

  • To analyze the characteristics of severe adverse events associated with pediatric intravenous anesthesia in Japan.
  • To identify trends and risk factors for medical accidents during pediatric procedural anesthesia.
  • To inform safety guidelines and improve patient outcomes.

Main Methods:

  • Analysis of a nationwide, anonymized Japanese accident registry database spanning 13 years.
  • Extraction and review of accident reports specifically concerning pediatric intravenous anesthesia for medical procedures.
  • Categorization and statistical analysis of reported severe adverse events based on patient demographics, underlying conditions, and procedures.

Main Results:

  • 79 accident reports were identified, representing 0.017% of total procedures.
  • The majority of accidents (88.6%) occurred in children aged 0-9 years.
  • Four deaths and eight cardiopulmonary arrests were reported, primarily in patients with serious underlying conditions undergoing prolonged, invasive procedures like cardiac catheterization.

Conclusions:

  • This study provides a national overview of severe adverse events in pediatric intravenous anesthesia in Japan.
  • Findings underscore the critical need for robust risk stratification protocols.
  • Emphasizes the importance of involving specialized anesthesia professionals in managing high-risk pediatric cases.
Abstract

Keywords:
accidentsapneacardiac arrestdeep sedationintravenous anesthesia

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