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Paediatric out-of-theatre procedural sedation at a tertiary children's hospital: A prospective observational study
Background: This tertiary referral centre is one the largest paediatric hospitals in Africa. Despite an increasing number of surgical and diagnostic procedures being performed annually, a formal out-of-theatre sedation service does not exist. Procedural sedation and analgesia (PSA) is an important a...
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| Format: | Thesis |
| Language: | English |
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Department of Anaesthesia and Perioperative Medicine
2022
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| _version_ | 1867613224295202816 |
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| access_status_str | Open Access |
| author | Lapere, Cherese |
| author2 | Gray, Rebecca |
| author_browse | Gray, Rebecca Lapere, Cherese |
| author_facet | Gray, Rebecca Lapere, Cherese |
| author_sort | Lapere, Cherese |
| collection | Thesis |
| description | Background: This tertiary referral centre is one the largest paediatric hospitals in Africa. Despite an increasing number of surgical and diagnostic procedures being performed annually, a formal out-of-theatre sedation service does not exist. Procedural sedation and analgesia (PSA) is an important adjunct in behavioural management for invasive procedures in children. Objective: A prospective, observational study was performed at RCWMCH, aimed primarily at defining the number of cases of PSA performed outside the operating theatre. Methods: Data was collected from all procedural out-of-theatre sedations performed over a period of three months, including ward patients and out-patient departments. All children < 13 years of age were included. Results: A total of 639 sedations were performed. Of these sedations, 288 (45.0%) paper responses were captured and analysed. The reported incidence of desaturation was 4.2% (12/288), laryngospasm 0.3% (1/288) and nausea and vomiting 2.4% (6/288). Three cases required conversion to general anaesthetic, and three cases were abandoned due to inadequate sedation. In 16.3% (47/288) of cases the clinician was an operator sedationist (the same person performing the sedation and the procedure). In 90.6% of cases the intravenous route was utilized, with dexmedetomidine, ketamine and propofol being the three most commonly used agents. Conclusion: 639 PSA events were recorded in 3 months. The 288 events analysed were safely performed with minimal serious reported events. These results compare favourably with international studies and provide quantitative evidence as a prelude to setting up a dedicated sedation service at our facility. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/35905 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:32:44.899Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2022 |
| publishDateRange | 2022 |
| publishDateSort | 2022 |
| publisher | Department of Anaesthesia and Perioperative Medicine |
| publisherStr | Department of Anaesthesia and Perioperative Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/35905 Paediatric out-of-theatre procedural sedation at a tertiary children's hospital: A prospective observational study Lapere, Cherese Gray, Rebecca Wilson, Graeme Anaesthesiology and Perioperative Medicine Background: This tertiary referral centre is one the largest paediatric hospitals in Africa. Despite an increasing number of surgical and diagnostic procedures being performed annually, a formal out-of-theatre sedation service does not exist. Procedural sedation and analgesia (PSA) is an important adjunct in behavioural management for invasive procedures in children. Objective: A prospective, observational study was performed at RCWMCH, aimed primarily at defining the number of cases of PSA performed outside the operating theatre. Methods: Data was collected from all procedural out-of-theatre sedations performed over a period of three months, including ward patients and out-patient departments. All children < 13 years of age were included. Results: A total of 639 sedations were performed. Of these sedations, 288 (45.0%) paper responses were captured and analysed. The reported incidence of desaturation was 4.2% (12/288), laryngospasm 0.3% (1/288) and nausea and vomiting 2.4% (6/288). Three cases required conversion to general anaesthetic, and three cases were abandoned due to inadequate sedation. In 16.3% (47/288) of cases the clinician was an operator sedationist (the same person performing the sedation and the procedure). In 90.6% of cases the intravenous route was utilized, with dexmedetomidine, ketamine and propofol being the three most commonly used agents. Conclusion: 639 PSA events were recorded in 3 months. The 288 events analysed were safely performed with minimal serious reported events. These results compare favourably with international studies and provide quantitative evidence as a prelude to setting up a dedicated sedation service at our facility. 2022-03-04T08:36:19Z 2022-03-04T08:36:19Z 2021 2022-03-01T09:01:49Z Master Thesis Masters MMed http://hdl.handle.net/11427/35905 eng application/pdf Department of Anaesthesia and Perioperative Medicine Faculty of Health Sciences |
| spellingShingle | Anaesthesiology and Perioperative Medicine Lapere, Cherese Paediatric out-of-theatre procedural sedation at a tertiary children's hospital: A prospective observational study |
| thesis_degree_str | Master's |
| title | Paediatric out-of-theatre procedural sedation at a tertiary children's hospital: A prospective observational study |
| title_full | Paediatric out-of-theatre procedural sedation at a tertiary children's hospital: A prospective observational study |
| title_fullStr | Paediatric out-of-theatre procedural sedation at a tertiary children's hospital: A prospective observational study |
| title_full_unstemmed | Paediatric out-of-theatre procedural sedation at a tertiary children's hospital: A prospective observational study |
| title_short | Paediatric out-of-theatre procedural sedation at a tertiary children's hospital: A prospective observational study |
| title_sort | paediatric out of theatre procedural sedation at a tertiary children s hospital a prospective observational study |
| topic | Anaesthesiology and Perioperative Medicine |
| url | http://hdl.handle.net/11427/35905 |
| work_keys_str_mv | AT laperecherese paediatricoutoftheatreproceduralsedationatatertiarychildrenshospitalaprospectiveobservationalstudy |