Anesthesia Options for Pediatric Endoscopy: A Review of Intravenous Sedation and General Anesthesia

Abstract

Gastrointestinal (GI) endoscopy has emerged as an indispensable tool for the assessment and management of GI disorders. Intravenous (IV) sedation and General Anesthesia (GA) are both employed to alleviate patient discomfort and ensure amnesia during these procedures. Essential aspects of both methods include vigilant monitoring of consciousness levels, pulmonary ventilation, oxygenation and hemodynamics. While GI endoscopy is generally regarded as safe, there is a potential for complications. This is particularly noteworthy in the context of pediatric patients. Raising awareness of the potential complications linked to sedation during GI endoscopy in children and involving anesthesiologists in their care is pivotal to ensuring safety. Several risk factors for complications were identified, including younger age, higher ASA (American Society of Anesthesiologists) class (indicating more severe health conditions) and the use of IV sedation. Documented adverse events encompassed issues such as inadequate sedation, diminished oxygen saturation, airway blockages, episodes of apnea necessitating bag-mask ventilation, patient agitation, occurrences of bleeding and cases of organ perforation. Statistical analysis revealed that complications were less frequent when GA was used (1.2%) compared to IV sedation (3.7%). Furthermore, IV sedation was found to be independently linked to a 5.3% higher risk of cardiopulmonary complications compared to GA. Consequently, GA can be considered a safer and more efficacious choice in providing comfort and amnesia during GI endoscopy.