| 11 th Annual Pediatric Critical Care Colloquium |
| Session/Time | Poster/Thu, 4:30 - 6:30 PM |
| Title | A Survey of Analgesia and Sedation Practices by Pediatric Intensivists in Canada |
| Author | R Singh, J Simons |
| Affiliation | Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada |
| Introduction | Providing analgesia and sedation for children is an important task for the pediatric intensivist (PI). There are however, differences in the scope of practice and choice of therapeutic agezts. The purpose of this study was to examine the current analgesia and sedation practices of the Pls in Canada and identify the reasons for any differences in practice patterns |
| Method | The names of all practising Pls were obtained by personal contact with all Canadian pediatric tertiary care centres. Questionnaires were nuiiled to each PI with a remainder four weeks later. We obtained demographic information including: primary speciality, age, sex, duration of practice and number of acirni sions to their PICU per year. Pls were asked to report: (i) the degree of sedation they provide, (ii) the agents they used for this purpose, (iii) their use of anesthetic agents, (iv) their reasons for not using anaesthetic agents, (v) whether their practice pattern was influenced by their hospital policies, (vi) whether they provide sedation and analgesia outside of PICU, (vii) their most likely choices for sedation and analgesia in four common clinical situations. We attempted to determine whether their choice of analgesia and sedative agents varied with their speciality training |
| Result | 42 (75%) of the 56 Pls responded. Primary speciality of the responders was: pediatrics 75%, anaesthesia 20%, others 5%. 100% of the Pls provided conscious sedation and deep sedation in the PICU and 92% of them electively intubated patients for procedures in the PICU. Over 95% of the responders routinely used thiopenw, ketannine and neuromuscular biockers but only 21 (65%) of the pediatric-traine d Pls used propofol compared to 7 (90%) of the anaesthesia-trained Pls in the PICU setting (Fisher's exact p=0.40). Of those who did not use propofol, 50% reported dmt it was due to hospitti policies restricting its use by non inaesthetist. Only 47% of the responders provided sedation for children outside of the PICU. In the case scenarios, most Pls used various combinations of agents with the only significant difference being the use of propofol. |
| Conclusion | Most padiitric intensivists practising in Canadian tertiary care centres provide conscious sedation, deep sedation and elective intimation for procedures within the PICU. Some Pis also provide these services oxiiilde of ilic PICU. There is widespread con mn The results of this survev will be used to help establish guidelines and training objectives for Cinadian Pls in providing anagesia and sedation. |
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