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Sedation in Pediatric Patients For Colonoscopy

Yıl 2019, Cilt: 13 Sayı: 5, 335 - 340, 23.09.2019
https://doi.org/10.12956/tchd.570489

Öz

longer. The aim of the study is to evaluate the applications of sedation in pediatric patients who underwent colonoscopy.

Material and Methods: Between 2012-2017, Gastrointestinal (GI) endoscopy cases under sedation were

retrospectively screened. Patients’ age, gender, indications, anesthetic drugs, procedure times and complications were

recorded. Patients were divided according to age groups. (Group 1:0-2 years, Group 2:2-6 years, Group 3:6-11 years,

Group 4:11-17 years)

Results: 273 patient files between 0-17 years of age were included in the study. gastroscopy + colonoscopy was

performed in 122 of the patients and colonoscopy was performed in 151 patients. 18 patients in group 1, 30 patients in

group 2, 32 patients in group 3, 4 patients in 71 patients underwent colonoscopy. Colonoscopy indications of patients

were rectal bleeding, chronic diarrhea, polyps, ülcerative colitis, Familial Mediterranean fever (FMF) crohn’s disease






and Celiac sprue. The mean duration of colonoscopy in Group 1: 40.9±16.9 min. Group 2: 41.3±13.3 min, Group 3:45.6±13 min, Group 4: 47±14.6 min. Sedation was administered with propofol in 65% and midazolam in 70% Ketamin in %13 of patients






in Group 1. There were no complications in this age group. Propofol was used in all patients in group 2 and midazolam was used in 80%


of the patients. 1 patient had developed bronchospasm. Propofol was used in all patients in group 3 and midazolam was used in 76% of


patients. 1 patient had bronchospasm and 1 patient had bradycardia. Propofol was used in all of the patients in group 4 and midazolam


was used in 77% of the patients. Complications were seen in 3 patients, including bradycardia in 1 patient and bronchospasm in 2


patients.


Conclusion: Consequently, while the GI endoscopy procedures might cause pain and mild discomfort for most patients there are still no


guidelines for standard methods for application of anesthesiology and further study is needed.

Kaynakça

  • 1. Yoshioka S, Takedatsu H, Fukunaga S, Kuwaki K, Yamasaki H, Yamauchi R, et al. Study to determine guidelines for pediatric colonoscopy. World journal of gastroenterology 2017;23:5773-9.
  • 2. Goulson DT, Fragneto RY. Anesthesia for gastrointestinal endoscopic procedures. Anesthesiology clinics 2009;27:71-85.
  • 3. Amornyotin S, Aanpreung P, Prakarnrattana U, Chalayonnavin W, Chatchawankitkul S, Srikureja W. Experience of intravenous sedation for pediatric gastrointestinal endoscopy in a large tertiary referral center in a developing country. Paediatric anaesthesia 2009;19:784-91.
  • 4. Chung HK, Lightdale JR. Sedation and Monitoring in the Pediatric Patient during Gastrointestinal Endoscopy. Gastrointest Endosc Clin N Am 2016;26:507-25.
  • 5. Dar AQ, Shah ZA. Anesthesia and sedation in pediatric gastrointestinal endoscopic procedures: A review. World J Gastrointest Endosc 2010;2:257-62.
  • 6. Cote CJ, Wilson S, Amerıcan Academy of Pediatrics; Amerıcan Academy of Pediatric dentıstry. Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures: Update 2016. Pediatrics 2016;138(1). pii: e20161212. doi: 10.1542/ peds.2016-1212.
  • 7. Lightdale JR. Sedation and analgesia in the pediatric patient. Gastrointest Endosc Clin N Am 2004;14:385-99.
  • 8. Ramsay MA, Savege TM, Simpson BR, Goodwin R. Controlled sedation with alphaxalone-alphadolone. Br Med J 1974;2:656-9.
  • 9. Gilger MA, Gold BD. Pediatric endoscopy: new information from the PEDS-CORI project. Curr Gastroenterol Rep 2005;7:234-9.
  • 10. Ishige T, Tomomasa T, Takebayashi T, Asakura K, Watanabe M, Suzuki T, et al. Inflammatory bowel disease in children: epidemiological analysis of the nationwide IBD registry in Japan. J Gastroenterol 2010;45:911-7.

Pediatrik Hastalarda Kolonoskopide Sedasyon

Yıl 2019, Cilt: 13 Sayı: 5, 335 - 340, 23.09.2019
https://doi.org/10.12956/tchd.570489

Öz

Çalışmanın amacı kolonoskopi yapılan pediatrik hastalarda sedasyon


uygulamalarının değerlendirilmesidir.


Gereç ve Yöntemler: 2012-2017 yılları arasında sedasyon altında gerçekleştirilen gastrointestinal endoskopi olguları


retrospektif olarak tarandı. Hastaların yaş, cinsiyet, endokopik girişim endikasyonları, kullanılan anestetik ajanlar, toplam


işlem süresi ve görülen komplikasyonlar kaydedildi. Hastalar yaşlarına göre gruplara [grup 1: 0-2 yaş (süt çocuğu), grup


2: 2-6 yaş (oyun çocuğu), grup 3: 6-11 yaş (büyük çocuk), grup 4: 11-17 yaş (ergen)] ayrıldı.


Bulgular: Çalışmaya 0-17 yaş arası 273 hasta dosyası dahil edildi. 122 hastaya gastroskopi + kolonoskopi, 151’ne


kolonoskopi uygulandığı tespit edildi. Kolonoskopi yapılan hasta sayıları grup 1: 18 hasta, grup 2: 30, grup 3: 32, grup 4:


71’di. Endokopik girişimlerin rektal kanama, kronik ishal, polip, ülseratif kolit, Ailevi Akdeniz Ateşi (AAA), kron ve çöliyak


hastalığı nedeniyle yapıldığı tespit edildi. Ortalama kolonoskopi süresi grup 1: 40.9±16.9 dk, grup 2: 41.3±13.3 dk.


grup 3: 45.6±13 dk., grup 4: 47±14.6 dk.’dı. Grup 1’deki hastaların %65’de propofol, %70’de midazolam ile sedasyon


sağlandığı ve bu yaş grubunda herhangi bir komplikasyonla karşılaşılmadığı gözlendi. Grup 2’deki hastaların tamamında


propofol, %80’de midazolam ile sedasyon uygulandığı tespit edildi. Komplikasyon olarak 1 hastada bronkospazm


görüldü. Grup 3’te hastaların tamamında propofol kullanıldığı, %76’ında midazolam kullanıldığı ve bu hasta grubunda 1


hastada bronkospazm 1 hastada bradikardi gözlendi. Grup 4’teki hastaların tamamında propofol, %77’de midazolam


kullanıldığı ve 1 hastada bradikardi, 2 hastada bronkospazm olmak üzere toplam 3 hastada komplikasyon tespit edildi.


Sonuç: Günümüzde pediatrik hastalarda Gİ endoskopik işlemler, ağrılı ve hoş olmayan girişimler olduğundan sedasyon


uygulaması rutin hale gelmekle birlikte uygulamada standartlar oluşturulamamıştır. Bu nedenle daha fazla çalışmaya


ihtiyaç olduğunu düşünüyoruz.

Kaynakça

  • 1. Yoshioka S, Takedatsu H, Fukunaga S, Kuwaki K, Yamasaki H, Yamauchi R, et al. Study to determine guidelines for pediatric colonoscopy. World journal of gastroenterology 2017;23:5773-9.
  • 2. Goulson DT, Fragneto RY. Anesthesia for gastrointestinal endoscopic procedures. Anesthesiology clinics 2009;27:71-85.
  • 3. Amornyotin S, Aanpreung P, Prakarnrattana U, Chalayonnavin W, Chatchawankitkul S, Srikureja W. Experience of intravenous sedation for pediatric gastrointestinal endoscopy in a large tertiary referral center in a developing country. Paediatric anaesthesia 2009;19:784-91.
  • 4. Chung HK, Lightdale JR. Sedation and Monitoring in the Pediatric Patient during Gastrointestinal Endoscopy. Gastrointest Endosc Clin N Am 2016;26:507-25.
  • 5. Dar AQ, Shah ZA. Anesthesia and sedation in pediatric gastrointestinal endoscopic procedures: A review. World J Gastrointest Endosc 2010;2:257-62.
  • 6. Cote CJ, Wilson S, Amerıcan Academy of Pediatrics; Amerıcan Academy of Pediatric dentıstry. Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures: Update 2016. Pediatrics 2016;138(1). pii: e20161212. doi: 10.1542/ peds.2016-1212.
  • 7. Lightdale JR. Sedation and analgesia in the pediatric patient. Gastrointest Endosc Clin N Am 2004;14:385-99.
  • 8. Ramsay MA, Savege TM, Simpson BR, Goodwin R. Controlled sedation with alphaxalone-alphadolone. Br Med J 1974;2:656-9.
  • 9. Gilger MA, Gold BD. Pediatric endoscopy: new information from the PEDS-CORI project. Curr Gastroenterol Rep 2005;7:234-9.
  • 10. Ishige T, Tomomasa T, Takebayashi T, Asakura K, Watanabe M, Suzuki T, et al. Inflammatory bowel disease in children: epidemiological analysis of the nationwide IBD registry in Japan. J Gastroenterol 2010;45:911-7.
Toplam 10 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular İç Hastalıkları
Bölüm ORIGINAL ARTICLES
Yazarlar

Cihan Döger Bu kişi benim

Yayımlanma Tarihi 23 Eylül 2019
Gönderilme Tarihi 18 Ocak 2018
Yayımlandığı Sayı Yıl 2019 Cilt: 13 Sayı: 5

Kaynak Göster

Vancouver Döger C. Pediatrik Hastalarda Kolonoskopide Sedasyon. Türkiye Çocuk Hast Derg. 2019;13(5):335-40.

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