Safety of Non-Operating Room Anesthesia With Propofol Sedation in Three Pediatric Patients With Central Sleep Apnea

Fiona Gruzmark, Nadia Shaikh, Shane C. Rainey, Keith A. Hanson
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Abstract

Children with central sleep apnea may require sedation for procedures, including brain imaging as part of the evaluation of apnea. However, the safety of deep sedation without a protected airway is not known in this patient population. In this case series, we present 3 children with central sleep apnea who were sedated with propofol for brain imaging in a non-operating room setting. All 3 did well with no complications; those with a home oxygen requirement were on oxygen during the procedure but none experienced apnea, desaturation, or respiratory distress. While obstructive sleep apnea is a known contraindication to deep sedation with propofol, it may be safe in pediatric patients with central sleep apnea. Deep sedation may be a good option for these patients, thereby avoiding the need for general anesthesia and placement of an advanced airway.
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3例小儿中枢性睡眠呼吸暂停患者非手术麻醉丙泊酚镇静的安全性
患有中枢性睡眠呼吸暂停的儿童可能需要镇静治疗,包括脑成像作为呼吸暂停评估的一部分。然而,没有气道保护的深度镇静在这一患者群体中的安全性尚不清楚。在这个病例系列中,我们报告了3名患有中枢性睡眠呼吸暂停的儿童,他们在非手术室环境下用异丙酚镇静进行脑成像。3例患者均无并发症;那些有家庭吸氧需求的患者在手术过程中需要吸氧,但没有人出现呼吸暂停、去饱和或呼吸窘迫。虽然阻塞性睡眠呼吸暂停是已知的异丙酚深度镇静的禁忌症,但对于中枢性睡眠呼吸暂停的儿科患者来说,它可能是安全的。对于这些患者来说,深度镇静可能是一个很好的选择,从而避免了全身麻醉和放置高级气道的需要。
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