• Paediatric anaesthesia · Jan 2011

    Multicenter Study

    The 'dark' side of sedation: 12 years of office-based pediatric deep sedation for electroretinography in the dark.

    • Kirk Lalwani, Brian D Tompkins, Kevin Burnes, Melissa R Krahmer, Mark E Pennesi, and Richard G Weleber.
    • Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Doernbecher Children's Hospital, Portland, OR 97239, USA. lalwanik@ohsu.edu
    • Paediatr Anaesth. 2011 Jan 1;21(1):65-71.

    ObjectivesAnalyze pediatric ERG data for adverse events, interventions, and outcomes of propofol sedations performed in near-complete darkness.AimTo demonstrate that deep sedation with propofol for ERG can be performed efficiently and safely in children in near-total darkness.BackgroundFull-field electroretinography (ERG) is a valuable tool for the diagnosis of vision loss in children. The ERG measures the electrical activity of the retina. In children, ERG quality significantly improves with deep sedation by allowing easier eye electrode placement and decreasing motion artifacts. As this procedure must be performed in darkness, administering sedation imposes unique challenges.Methods And MaterialsERGs are performed outside of the operating room in our hospital's electrophysiology suite. IVs are placed, and patients are allowed to adapt to complete darkness. An anesthesiologist then administers propofol sedation in the dark with the aid of a red-filter light source and monitor light shields. Data were collected on 379 patients (411 ERGs) performed from 1996 to 2008. These records were reviewed and analyzed for demographic, medical, and anesthetic data.ResultsPropofol sedation resulted in an ERG completion rate of 99.5%. During sedation, 8.5% (35) of patients experienced minor respiratory complications such as airway obstruction that resulted in an oxygen saturation <90%. A total of 9.7% (40) of patients required minor airway interventions such as a chin lift.ConclusionsWe demonstrated that pediatric sedation is a safe, efficient, and a cost-effective method for measuring ERGs in a challenging environment. The incidence of minor complications is low and appears similar to other studies of propofol sedation.© 2010 Blackwell Publishing Ltd.

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