Related Experiment Videos
A survey of pentobarbital sedation for children undergoing abdominal CT scans after oral contrast medium
1British Columbia Children's Hospital, Vancouver, Canada.
Insights
Pediatric sedation for CT scans using oral contrast medium (OCM) with pentobarbital showed no failed sedations. However, complications like desaturation and airway issues occurred in 14.7% of cases.
Area of Science:
- Pediatric Anesthesiology
- Radiology
- Pharmacology
Background:
- Traditionally, radiologists manage pediatric sedation for imaging.
- Increasing involvement of anesthesiologists in pediatric procedural sedation.
- Oral contrast medium (OCM) in children undergoing CT scans presents unique sedation challenges.
Purpose of the Study:
- To evaluate the safety and efficacy of intravenous pentobarbital for sedating children undergoing CT scans after OCM ingestion.
- To identify common complications associated with this sedation protocol.
Main Methods:
- Retrospective survey of 149 pediatric patients (3 months to 7 years) undergoing upper abdominal CT.
- Intravenous pentobarbital was the primary sedative agent (average dose 4.6 mg/kg).
- Supplementary sedation (midazolam +/- fentanyl) was used in a small subset of patients.
Main Results:
- No failed sedations were recorded.
- 141 patients (94.6%) received pentobarbital alone.
- 36 complications occurred in 22 sedations (14.7%), including desaturation, vomiting, and airway obstruction.
Conclusions:
- Intravenous pentobarbital is an effective sedative for pediatric CT scans with OCM, with a low failure rate.
- Close monitoring is essential due to potential complications such as respiratory events and airway issues.
Abstract:
Radiologists have traditionally been responsible for the sedation of children undergoing radiological investigations. Anaesthetists are becoming increasingly involved in providing sedation and/or anaesthesia in this environment. The sedation of a child for a CT scan who has recently been given oral contrast medium (OCM) may pose anaesthetists a number of dilemmas. This is a retrospective survey of 149 intravenous pentobarbital sedations administered by radiologists to children (age range three months to seven years three months, weight range 5 kg to 28.9 kg) undergoing upper abdominal CT after recent ingestion of OCM. The average patient received pentobarbital 4.6 mg.kg-1. 141 patients (94.6%) received pentobarbital as the only sedative agent, whereas eight patients (5.4%) required supplementary sedation (midazolam +/- fentanyl). There were no failed sedations. 36 complications occurred during 22 sedations (14.7% of total), with the most common being desaturation, vomiting, airway secretions, airway obstruction, coughing and bronchospasm.