Effect of parental presence on intravenous sedation in children with cyanotic heart disease undergoing CT angiography: a prospective randomized trial.
Ajay Singh, B Naveen Naik, Shweta Aghi et al.
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In 30 seconds
This prospective randomized trial assessed whether a parent’s presence affects intravenous sedation for CT angiography in 60 children aged 6 months to 3 years with cyanotic congenital heart disease. Children were sedated either on their mother’s lap or on the CT table. The mother’s lap group required less ketamine to reach the target sedation state: the between-group difference was - 0.15 mg/kg (95% CI - 0.29 to - 0.01; p = 0.03). This group also had lower preoperative anxiety scores and shorter recovery times, without an increase in adverse events.
Key findings
- Ketamine requirements were lower for children sedated on their mother’s lap (- 0.15 mg/kg, 95% CI - 0.29 to - 0.01; p = 0.03).
- Recovery time was shorter in the mother’s lap group (- 3 min, 95% CI - 4.08 to - 1.92).
- Preoperative anxiety scores were lower with maternal presence; the abstract does not report the numerical difference.
- No increase in adverse events was reported with maternal presence.
Why it matters
Intravenous sedation for diagnostic imaging can be challenging in young children with cyanotic heart disease. In this randomized trial, having the child remain on the mother’s lap was associated with lower ketamine requirements, less preoperative anxiety, and faster recovery, without more adverse events. These findings suggest that the setting and presence of a parent may be relevant components of procedural sedation in this high-risk population.
What to keep in mind
The trial included 60 children aged 6 months to 3 years with cyanotic congenital heart disease; the abstract does not establish whether the findings generalize to other ages, conditions, or imaging settings.