Pediatric Fellowship-Trained Anesthesiologists Improve Anesthesia-Controlled Time in a Pediatric Endoscopy Suite. 2023

Adlei Carlson, and Angela McElrath, and Germaine Herrera, and Michael Patzkowski
From the Department of Anesthesiology, Brooke Army Medical Center, Fort Sam Houston, TX.

The objective of this study was to determine the difference in anesthesia-controlled time (ACT) between subspecialty-trained pediatric anesthesiologists and general anesthesiologists during esophagogastroduodenoscopy (EGD) and colonoscopy. We hypothesized pediatric anesthesiologists would demonstrate a shorter ACT compared to general anesthesiologists. We conducted a retrospective analysis of pediatric endoscopy cases requiring general endotracheal anesthesia within our pediatric sedation unit from 2017 to 2020. Demographic and procedural variables were collected and assessed for potential confounding. The imbalance in baseline variables was controlled for utilizing a generalized linear model (GLM). The GLM had a model fit of adjusted R2 = 0.146 and was statistically significant with P < 0.001. A priori power analysis was performed for a 2-tailed independent means t test with alpha = 0.05, and Power = 0.80, which revealed a minimum sample size of 64 patients per group to detect a mean difference of 3 minutes of ACT. A total of 269 cases met inclusion criteria. Adjusted results demonstrated fellowship-trained pediatric anesthesiologists were associated with a 3.7-minute (95% CI: 2.005-5.478; P < 0.001) reduction in ACT when compared to general practice anesthesiologists. Patient age was associated with a 0.4-minute (95% CI: -0.558 to -0.243; P < 0.001) decrease in ACT for each advancing year in age. We observed an association between the subspecialty training of the anesthesiology provider and ACT for EGDs and colonoscopies. When EGDs and colonoscopies are performed under the supervision of pediatric anesthesiologists, ACT reduction potentially reduces cost and improves efficiency.

UI MeSH Term Description Entries
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D005257 Fellowships and Scholarships Stipends or grants-in-aid granted by foundations or institutions to individuals for study. Scholarships,Fellowships,Fellowship,Scholarship,Scholarships and Fellowships
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000072080 Anesthesiologists Physicians specializing in ANESTHESIOLOGY. Physician Anesthetists,Anesthesiologist,Anesthetist, Physician,Anesthetists, Physician,Physician Anesthetist
D000758 Anesthesia A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures.
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D016099 Endoscopy, Gastrointestinal Endoscopic examination, therapy or surgery of the gastrointestinal tract. Endoscopic Gastrointestinal Surgical Procedures,Surgical Procedures, Endoscopic Gastrointestinal,Endoscopic Gastrointestinal Surgery,Gastrointestinal Endoscopic Surgical Procedures,Procedure, Endoscopic Gastrointestinal, Surgical,Procedure, Gastrointestinal Endoscopic Surgical,Procedures, Endoscopic Gastrointestinal, Surgical,Procedures, Gastrointestinal Endoscopic Surgical,Surgical Procedure, Endoscopic Gastrointestinal,Endoscopic Gastrointestinal Surgeries,Endoscopies, Gastrointestinal,Gastrointestinal Endoscopies,Gastrointestinal Endoscopy,Gastrointestinal Surgeries, Endoscopic,Gastrointestinal Surgery, Endoscopic,Surgeries, Endoscopic Gastrointestinal,Surgery, Endoscopic Gastrointestinal

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