Anesthesia for Voiding Cystourethrograms in Pediatric Patients

Webb, Eric; Goodwin, Willard E.

doi:10.1016/s0022-5347(17)60181-2

Cited by 7 publications

(2 citation statements)

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“…15, 16 A thorough literature review discloses an unusual recommendation (expressed in the early 1970s) to insert the catheter with the patient under short general anesthesia achieved by N 2 O and halothane, which was immediately discontinued thereafter to enable the child to void. 17 Understandably, this approach never gained popularity as it requires 2 anesthetists, and is associated with retching and vomiting. Only 2 decades later Elder and Longenecker presented their experience concerning pre-medication with oral midazolam for VCU in children.…”

Section: Discussionmentioning

confidence: 99%

Sedation During Voiding Cystourethrography: Comparison of the Efficacy and Safety of Using Oral Midazolam and Continuous Flow Nitrous Oxide

et al. 2005

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Section: Discussionmentioning

confidence: 99%

Sedation During Voiding Cystourethrography: Comparison of the Efficacy and Safety of Using Oral Midazolam and Continuous Flow Nitrous Oxide

et al. 2005

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“…These techniques include psychological preparation, conscious sedation, and general anesthesia. [4][5][6][7][8][9] The feasibility and safety of VCUG under general anesthesia in children was first described in 1966 by McDonald et al 10 A few years later, Downing et al described a successful dual performance of cystography and cystoscopy under general anesthesia in seven children with VUR. 9 However, sensitivity or negative predictive value (NPV) could not be deduced from their results.…”

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confidence: 99%

The accuracy of cystography under general anesthesia in children with vesicoureteral reflux

Frumer

Sivan

May

et al. 2022

Neurourology and Urodynamics

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To examine the accuracy of cystography under general anesthesia in children with vesicoureteral reflux (VUR). Materials and Methods: A prospective study of children who had VUR on cystography without general anesthesia (i.e., the gold-standard), and who are candidates for endoscopic VUR repair surgery. All children subsequently underwent a cystography under general anesthesia before injection using standardized method, which was compared to the gold-standard cystography. χ 2 and Mann-Whitney U tests were used to compare proportions and medians between groups.Results: Between 2017 and 2021, 126 renal units in 13 boys and 50 girls were included. Median age was 3.4 years (interquartile range [IQR] 1.5−6.5).Median time from cystography without to cystography with general anesthesia was 3.8 months (IQR 2.7−6). Of the 126 renal units, 96 had VUR on cystography without general anesthesia. On dichotomous analysis (no VUR vs. any VUR) sensitivity, specificity, negative and positive predictive values of cystography under general anesthesia were 47% (45/96), 87% (26/30), 34% (26/77) and 92% (45/49), respectively. Accuracy was 56.3%; Cohen's Kappa coefficient was 0.22, indicating poor agreement. In subgroup analysis, the sensitivity of cystography under general anesthesia was significantly lower in primary VUR (20% vs. 55% in secondary VUR, p = 0.01) and active VUR (14% vs. 52% in passive VUR, p = 0.008). Conclusion:Cystography under general anesthesia was poorly correlated to cystography performed while the child was awake or lightly sedated. Clinical decision relying on this cystography is questionable.

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Conscious Dynamic Versus Unconscious Static Cystourethrography

Arnold

Berg

1977

Journal of Urology

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Prior to treatment 30 urologically symptomatic subjects were studied with dynamic voiding cystourethrography while conscious and with single shot high pressure static cystourethrography while anesthetized. The former technique did not surpass the latter in demonstrating reflux, lower urinary tract disease or urethral anatomical detail. It is concluded that (problem cases aside) when management requires anesthetizing the patient only the high pressure, single shot static method should be used and that omission of premedication and manipulation of anesthetic planes to produce voiding are neither necessary nor desirable.

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Anesthesia for Voiding Cystourethrograms in Pediatric Patients

Cited by 7 publications

References 0 publications

Sedation During Voiding Cystourethrography: Comparison of the Efficacy and Safety of Using Oral Midazolam and Continuous Flow Nitrous Oxide

Sedation During Voiding Cystourethrography: Comparison of the Efficacy and Safety of Using Oral Midazolam and Continuous Flow Nitrous Oxide

The accuracy of cystography under general anesthesia in children with vesicoureteral reflux

Conscious Dynamic Versus Unconscious Static Cystourethrography

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