Objectives: Gastrointestinal (GI) endoscopic procedures are standard of care for the diagnosis and treatment of several GI conditions. These procedures may be associated with discomfort, pain and anxiety, especially in paediatric population. Predictors for complicated recovery after endoscopies, however, are not known. The aim of our study was to identify risk factors for complicated recovery after GI endoscopic procedures in children.
Methods: We included children that were electively admitted for GI endoscopies at the pediatric gastroenterology unit, "Dana-Dwek" Children`s Hospital during 2016. We collected demographic, clinical and endoscopic data. Numerical rating scale (NRS) and Faces, Legs, Activity, Cry, and Consolability (FLACC) scales were used for pain scoring.
Results: A total of 284 children were included: 117 (41.2%) males and 167 (58.8%) females, with a median age (IQR) of 10.7 (6.7-14.8) years. Upper GI endoscopy was performed in 268 (94.3%) and lower GI endoscopy in 84 (29.5%). Sedation included propofol in all children in addition to gas induction (sevofluran) in 34 (12%) and midazolam in 51 (18.1%). In a multivariate analysis, older age (OR 1.017, P<0.001), higher pain score before the procedure (OR 7.93, P<0.001), longer procedure (OR 1.027, P=0.005) and higher number of biopsies (OR 1.304, P<0.001) were associated with higher pain score after the procedure. Children with diagnosis of celiac disease presented lower pain score after the procedure (OR 0.4, P=0.05). Patients with higher pain score before the procedure had longer recovery time (OR 5.28, P=0.001).
Conclusions: We identified several predictors for higher pain score after GI endoscopies in children. Children with these risk factors should be identified before the procedure in order to be appropriately managed.
