Postdischarge adverse events related to sedation for diagnostic imaging in children

OBJECTIVES: The objectives of this study were to describe the type and frequency of postdischarge adverse events related to sedation for elective diagnostic imaging in children and to determine if any patient or drug characteristics were associated with such adverse events. METHODS: We conducted a prospective observational study of children younger than 18 years who underwent sedation for elective magnetic resonance imaging at a tertiary care hospital. We administered a postdischarge adverse event questionnaire to families within 3 to 5 days after sedation to assess adverse events such as behavioral changes, vomiting, recovery time to baseline status, and need for medical follow-up. RESULTS: We enrolled 322 patients, of which 253 (78.5%) completed phone follow-up. The majority of study patients were male (58.1%) and belonged to American Society of Anesthesiologists category 2 (52.2%). A combination of pentobarbital and midazolam (53.4%) was the most commonly used sedation medication; 64.4% patients experienced postdischarge adverse events. The most common postdischarge adverse event reported were incoordination of movements (53.8%), dizziness (31.2%), and agitation (19.8%); 48.6% of patients required more than 9 hours to return to baseline behavior. No patient required evaluation at a medical facility for these postdischarge adverse events. Logistic regression analysis showed that use of pentobarbital and adverse event during sedation were significantly associated with postdischarge adverse events. CONCLUSIONS: Postdischarge adverse events related to sedation for diagnostic imaging are minor, mostly behavioral, but occur in a significant number of patients. Parents should be provided with detailed discharge instructions to anticipate such adverse events at home.