Imagers trim pediatric sedation and anesthesia over 11-year period
Imaging providers have decreased the use of anesthesia and sedation among children over the past decade, according to a new analysis published in JAMA Pediatrics [1].
The percentage of CT and MRI encounters that used these two techniques to calm patients during procedures dropped from about 13% in 2012 to 12% last year. Pediatric patients of age 1 or older, those imaged with IV contrast material, living in rural locations and with a higher acuity had greater odds of receiving sedation or anesthesia, experts noted.
“Nationally, we report a small but significant, 11-year decrease in sedation/anesthesia for CT and MRI examinations in pediatric EDs,” Shireen E. Hayatghaibi, PhD, with the Department of Radiology at Cincinnati Children’s Hospital, and co-authors wrote Aug. 14. “Despite prior single-center studies highlighting reductions in sedation/anesthesia for imaging, only a 1–percentage point decline has occurred nationally, likely confounded by persistent variation in sedation/anesthesia use for imaging across pediatric EDs.”
Researchers gathered their information from the Pediatric Health Information System, an administrative database maintained by the Children’s Hospital Association. They included all individuals under 18 who were discharged from a U.S. ED after receiving MRI and/or CT between 2012-2022. The analysis was restricted to only 33 EDs that contributed data during the study period.
Altogether, there were nearly 620,000 encounters involving almost 560,000 children, at an average age of 8.6, during this time span. About 13.2% of instances (81,783/619,892) involved anesthesia/sedation during the entire study period. The proportion dropped from 13.1% (6,696/51,120) in 2012 down to 12.1% (9,168/75,748), with the total number of encounters leaping more than 48% during that period.
Black and Hispanic children had lower odds of receiving sedation or anesthesia when compared to white children, the analysis found. The same went for encounters after 2017 and for children with complex chronic conditions. Hayatghaibi et al. also found wide variation from one hospital to the next, with anesthesia/sedation rates as low as 4.5% and high as 24.7%.
“Continued improvement in imaging techniques and development of clinical practice guidelines may further reduce the frequency and variation in sedation/anesthesia use for CT and MRI examinations,” the authors noted.
Read more in JAMA at the link below.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.