• Michelle L Noga, Julie E Yarr, and Philip E Chen.
• Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada. mnoga@ualberta.ca
• Can Assoc Radiol J. 2012 Aug 1;63(3):222-7.

BackgroundSevoflurane anesthetic has recently been administered by anesthesiologists during voiding cystourethrograms in a centre where radiologists are not permitted to deliver pediatric sedation.ObjectiveTo determine whether sevoflurane is a satisfactory anesthetic agent for voiding cystourethrography in children.MethodsRecords of children undergoing voiding cystourethrogram while they were under sevoflurane were reviewed for anesthetic adverse effects and diagnostic quality of the cystourethrogram. The occurrence of on-table voiding and post-void residual bladder volume were documented and compared with an age- and sex-matched control group of children undergoing unsedated voiding cystourethrography. The caregivers were surveyed regarding the anesthetic experience.ResultsA total of 91 children underwent sevoflurane voiding cystourethrography; there were no adverse cardiorespiratory events. Voiding was observed in 96%, with residual bladder volumes minimal in 38%, moderate in 32%, and large in 28% of anesthetized children, not significantly different from the control group. Vesicoureteral reflux was observed in 53% of examinations under sevoflurane. When children with a previous history of reflux or voiding cystourethrography were excluded in a comparison with age- and sex-matched controls, vesicoureteral reflux was observed in 38% of studies under sevoflurane and in 44% of studies in the control group, P = .69; 85% of caregivers of children with prior unsedated voiding cystourethrography found voiding cystourethrography with sevoflurane easier than without sevoflurane; 89% thought the anesthetic experience reduced their child's anxiety towards medical procedures.ConclusionNo adverse events or effects on diagnostic quality of the pediatric voiding cystourethrogram were encountered when using sevoflurane. The majority of surveyed caregivers thought that anesthesia made voiding cystourethrography an easier experience for their child.Copyright © 2012 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

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