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Intravenous sedation in pediatric upper gastrointestinal endoscopy
E Chuang1, W J Wenner, D A Piccoli
1Division of Gastroenterology and Nutrition, Children's Hospital of Philadelphia, University of Pennsylvania Medical School 19104, USA.
Gastrointestinal Endoscopy
|August 1, 1995
Summary
Fentanyl and midazolam sedation for pediatric upper endoscopy is safe and effective, leading to shorter recovery times and reduced midazolam dosage compared to meperidine and midazolam.
Area of Science:
- Pediatric Gastroenterology
- Anesthesiology
- Pharmacology
Background:
- Intravenous sedation is commonly used in pediatric procedures.
- Assessing sedation safety and efficacy is crucial for patient outcomes.
Purpose of the Study:
- To evaluate the safety and efficacy of two intravenous sedation regimens in pediatric upper endoscopy.
- Compare meperidine/midazolam versus fentanyl/midazolam combinations.
Main Methods:
- Retrospective review of 614 elective outpatient pediatric upper endoscopies.
- Analysis of sedation regimens: meperidine/midazolam (n=553) and fentanyl/midazolam (n=61).
- Comparison of medication doses, recovery times, and adverse events.
Main Results:
- Both regimens were safe and effective, with <1% procedure incompletion.
- Fentanyl/midazolam required lower midazolam doses (0.05 vs. 0.08 mg/kg) and had shorter recovery times (74.7 vs. 95.1 minutes).
- 19.1% experienced mild, transient side effects; none had sequelae.
Conclusions:
- Both meperidine/midazolam and fentanyl/midazolam are safe and effective for pediatric sedation during upper endoscopy.
- Fentanyl/midazolam offers advantages of reduced midazolam requirement and faster recovery.
- These findings support informed sedation choices for pediatric endoscopic procedures.