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Is higher ASA class associated with an increased incidence of adverse events during procedural sedation in a pediatric emergency department?
Is higher ASA class associated with an increased incidence of adverse events during procedural sedation in a pediatric emergency department?
- Source :
-
Pediatric emergency care [Pediatr Emerg Care] 2009 Oct; Vol. 25 (10), pp. 661-4. - Publication Year :
- 2009
-
Abstract
- Objective: To prospectively investigate whether American Society of Anesthesiologists (ASA) class, as assigned by nonanesthesiologists, is associated with adverse events during procedural sedation in a pediatric emergency department.<br />Methods: A prospectively collected database of children aged 0 to 21 years undergoing procedural sedation in the emergency department of an urban, tertiary care, children's hospital was retrospectively reviewed. This database included clinical and demographic characteristics, including assigned ASA class. It also included information relative to the procedure, the sedation, and any complications related to the sedation. Complications were defined a priori as persistent oxygen desaturation to less than 93% on pulse oximetry requiring supplemental oxygen, bronchospasm, dizziness, apnea, seizure, hiccoughs, laryngospasm, stridor, arrhythmia, hypotension, rash, vomiting, aspiration, or a disinhibition/agitation/dysphoria emergence reaction. Main outcome measure was the incidence of complications relative to ASA class.<br />Results: Procedural sedation was performed in the emergency department 1232 times during the study period; 30 sedations did not have either ASA class or occurrence of a complication recorded. Thus, 1202 sedations were included in the study. Nine hundred eighty-eight patients were classified as ASA class 1, whereas 214 were classified as ASA class 2 or greater. There were a total of 215 adverse events in the study population. Most of these were hypoxia (185 total) and were more likely to occur in patients with an ASA class 2 or greater (P = 0.021).<br />Conclusions: Adverse events during procedural sedation are more common in patients with higher ASA class.
- Subjects :
- Adolescent
Chi-Square Distribution
Child
Child, Preschool
Female
Humans
Infant
Infant, Newborn
Male
Pennsylvania
Prospective Studies
Retrospective Studies
Statistics, Nonparametric
United States
Young Adult
Conscious Sedation adverse effects
Conscious Sedation classification
Emergency Service, Hospital
Subjects
Details
- Language :
- English
- ISSN :
- 1535-1815
- Volume :
- 25
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Pediatric emergency care
- Publication Type :
- Academic Journal
- Accession number :
- 21465695
- Full Text :
- https://doi.org/10.1097/pec.0b013e3181bec7cc