Experience of intravenous sedation for pediatric gastrointestinal endoscopy in a large tertiary referral center in a developing country SOMCHAI AMORNYOTIN MD MD *, PRAPUN AANPREUNG MD MD †, UNGKAB PRAKARNRATTANA MD MD *, WIYADA CHALAYONNAVIN BN BN *, SUKANDA CHATCHAWANKITKUL BN BN * AND WICHIT SRIKUREJA MD MD ‡ *Department of Anesthesiology, †Department of Pediatric, and ‡Siriraj GI Endoscopy Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand Summary Background: The aim of this study was to evaluate the clinical efficacy of intravenous sedation for pediatric gastrointestinal endoscopy (GIE) at a tertiary care teaching hospital in a developing country. Methods: We undertook a retrospective review of the sedation service records of pediatric patients who underwent GIE. All endoscopies were performed by a pediatric gastroenterologist. All of the sedation was administered by staff anesthesiologist or anesthetic personnel in the gastroenterology procedure room. Results: Sedation was provided for 222 procedures in 214 patients ranged in age from younger than 1 to 17 years and in weight from 2.7 to 80.0 kg. Intravenous sedation was provided in 176 patients (82.2%). Of these patients, 185 procedures were performed and reviewed, with 152 (82.2%) procedures were esophagogastroduodenoscopy (EGD) alone, 14 (7.6%) procedures were colonoscopy alone, 18 (9.7%) procedures were EGD and colonoscopy, and one procedure was endoscopic ultrasonography (EUS). Most common indications of the procedure were screening for esophageal varices (25.2%), abdominal pain (15.9%), history of upper gastrointestinal hemorrhage (13.6%), and unexplained anemia (10.3%). The majority of preanesthetic problems were hematologic disease, anemia (38.2%); liver disease, cirrhosis (13.5%); and electrolyte imbalance (13.5%). Propofol (94.0%), fentanyl (87.0%), and midazolam (67.8%) were frequently used. The mean dose of propofol was 7.8 ± 4.1 mgÆkg )1 Æh )1 , fentanyl 2.3 ± 1.1 mcgÆkg )1 Æh )1 , and midazolam 0.1 ± 0.1 mgÆkg )1 Æh )1 . Most of them were used in combination. The combination of propofol, fentanyl, and midazolam was commonly employed (46.4%). The mean sedation time of all procedures was 28.2 min and was different according to procedure type. Complications occurred infrequently (13.5%) and were medication or airway related. All complications were easily treated, with no adverse sequelae. Intravenous sedation Correspondence to: S. Amornyotin, Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700 Thailand (email: sisam@mahidol.ac.th). Pediatric Anesthesia 2009 19: 784–791 doi:10.1111/j.1460-9592.2009.03063.x 784 Ó 2009 Blackwell Publishing Ltd