Deep sedation outside OR may be option for pediatric eye procedures
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Deep sedation used outside of the operating room may be a convenient alternative to general anesthesia in pediatric eye procedures, according to a poster presentation.
“Most pediatric eye procedures need some form of sedation/anesthesia,” Adriana P. Grigorian, MD, and colleagues wrote in the poster at the virtual American Association for Pediatric Ophthalmology and Strabismus annual meeting. “Deep sedation outside the OR has not been well studied; however, it offers numerous advantages for the providers and patients compared to general anesthesia in the operating room.”
Grigorian and colleagues conducted a retrospective review of 125 consecutive subjects who received deep sedation for ophthalmology procedures including nasolacrimal duct stenting and chalazion removal. Medications included propofol, fentanyl and ketamine. Patients who received deep sedation were compared with a control group of 1,037 patients who received sedation for similarly invasive procedures such as intrathecal chemotherapy administration, bone marrow aspiration and biopsies.
Nineteen patients (15.2%) in the ophthalmology deep sedation group experienced side effects compared with 3.8% of cases in the control group (P < .001). Side effects, which included 17 respiratory events, one case of benign arrythmia and one allergic reaction, were minor and “easily” managed.
Patients who experienced complications received a larger dose of medication (P = .009).
All ophthalmology procedures were successfully completed vs. 96% in the control group.
“No subjects required cardiopulmonary resuscitation or unplanned hospital admission,” Grigorian said at the meeting. “The eye procedures registered a higher rate of side effects than the control group, but all were completely successful.”
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Evans M, et al. Deep sedation for ophthalmology procedures outside of the operating room. Presented at: American Association for Pediatric Ophthalmology and Strabismus annual meeting; April 9-11, 2021 (virtual meeting).
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