Incidence of complications after nonoperating room anesthesia in children in a low- and middle-income country: A prospective and observational study.

ABSTRACT

INTRODUCTION: Nonoperating room anesthesia is a growing field of medicine that can have an increased risk of complications, particularly in low- and middle-income countries. AIMS: The aim of this study was to describe the incidence of complications after pediatric nonoperating room anesthesia and investigate its risk factors. METHODS: In this prospective observational study, we included all children aged less than 5 years who were sedated or anesthetized in the radiology setting of a university hospital in a low- and middle-income country. Patients were divided into two groups complications or no-complications groups. Then, we compared both groups, and univariable and multivariable logistic regression models were used to investigate the main risk factors for complications. RESULTS: We included 256 children, and the incidence of complications was 8.6%. The main predictors of nonoperating room anesthesia-related morbidity were critically-ill children (aOR = 2.490; 95% CI 1.55-11.21), predicted difficult airway (aOR = 5.704; 95% CI 1.017-31.98), and organization insufficiencies (aOR = 52.6; 95% CI4.55-613). The preanesthetic consultation few days before NORA protected against complications (aOR = 0.263; 95%CI 0.080-0.867). CONCLUSIONS: The incidence of complications during NORA among children in our radiology setting remains high. Investigating predictors for morbidity allowed high-risk patient selection, which allowed taking precautions. Several improvement measures were taken to address the organization's insufficiencies.