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Procedural Sedation for Pediatric Patients: Retrospective Comparison of Intravenous Deep Sedation and General Anesthesia: Research Report

Background: Pediatric patients may require sedation for prolonged imaging studies and painful procedures outside the operating room. Such procedures may be done under intravenous deep sedation or general anesthesia. Aim: This study compares the cost and recovery time between intravenous deep sedation and general anesthesia for such procedures. Method: A retrospective chart review comparing the use of intravenous deep sedation and general anesthesia for procedural sedation was conducted for children under 18 years old undergoing outpatient sedation for magnetic resonance imaging. Results: Out of 157 procedures, 94 received general anesthesia with sevoflurane (60%) and 63 (40%) intravenous deep sedation with propofol. Only one complication occurred. Age and body weight were similar in both groups. Cost of sedation for general anesthesia (mean $1712; 95% confidence interval, 1611-1812) was higher than for intravenous deep sedation (mean $674; 95% confidence interval, 556-793), p<0.001. Similarly post sedation recovery time (mean 56 min; 95% confidence interval, 49-63) was higher with general anesthesia than intravenous deep sedation (mean 37 min; confidence interval, 32-42), p<0.001. The results did not change after controlling for American Society of Anesthesiologists Physical Status (ASA) grade and duration of sedation.There was no reason given for scheduling to general anesthesia on 60% of cases, and 19% were scheduled just for the convenience of choice of day. Conclusions: Cost to patient and time to discharge post sedation may be lower with intravenous deep sedation as compared to general anesthesia. Therefore, protocols to correctly triage patients based on risk of airway compromise may be important.


Basnet S, Nicolas L and Koirala J

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