Anestesia e Pesquisa Clínica
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Anesthetic Management and Prevalence of Complications in Pediatric Upper Gastrointestinal Endoscopies

Deepti Manjunath and Chandrakala KR

Pediatric gastrointestinal endoscopy is emerging as a fundamental component of health care for infants and children. Adults tolerate these procedures well with minimal sedation, however, deep sedation or general anesthesia is mandatory in children to successfully perform these procedures. Adverse events, especially respiratory complications, during diagnostic and therapeutic endoscopy in children are common. Diagnosis, prevention and treatment of complications are crucial while performing pediatric endoscopy. Cooperation between pediatrician, pediatric endoscopist and pediatric anesthesiologist should guarantee quality and safety of the procedure and should help in reducing the perioperative respiratory complications along with surgical complications like bleeding and perforation.

Aims: Goals of this study were to assess prevalence of perioperative complications in pediatric upper gastrointestinal endoscopies. Secondary objective was to study the association between occurrence of perioperative complications with age of the patient and indication for which the child underwent endoscopy.

Methodology: This prospective observational study was conducted using the data of 100 children of ASA grades 1, 2 and 3 between the age group 6 months-15 years, who underwent diagnostic and therapeutic endoscopies in one year at our tertiary care hospital. Data was analyzed using the software Rv 3.5.1. Statistical tests applied were Kruskal-Wallis rank sum test, Chi Square test and descriptive statistics.

Results: Our study showed statistical significance with age and respiratory complications. Respiratory complications noted were primarily bronchospasm and aspirations. These complications were more common in age less than 1.5 years. No statistical significance was found between respiratory complications and type of anesthesia.

Conclusion: From our study we conclude that infants are at increased risk of respiratory complications during endoscopies under general anesthesia.