Deep Sedation Versus General Anesthesia in Pediatric Transesophageal Echocardiography: A Retrospective Comparative Study

Abstract

Objectives: To investigate the effects of deep sedation and general anesthesia on postprocedural recovery and cardiorespiratory complications in pediatric patients undergoing nonoperative transesophageal echocardiography (TEE). Design: A retrospective study of consecutive anesthesia-assisted TEE interventions performed between January 2017 and December 2023. Setting: A single institution. Participants: Pediatric patients who underwent TEE under deep sedation or general anesthesia. Interventions: Patients were divided into two groups: Group 1 consisted of patients who underwent deep sedation, and group 2 consisted of patients who underwent general anesthesia. In group 1, patients were divided into 3 subgroups as patients who used ketamine (group K), ketofol (group KF) and propofol (group P). In group 2, subgroups were examined as those receiving desflurane (group D) and sevoflurane (group S). Measurements and Main Results: A total of 147 pediatric patients undergoing nonoperative TEE were retrospectively analyzed, including 87 females (59.2%) and 60 males (40.8%). The mean duration of recovery was significantly longer in group 2 (10.98 ± 2.14 minutes) compared with group 1 (7.26 ± 1.94 minutes) (p < 0.001). Postprocedural hypotension, hypoxia, bronchospasm and laryngospasm occurred similarly between groups 1 and 2 (p > 0.05 for each). No significant difference was observed in the duration of recovery between the subgroups of group 1 (p = 0.504) Additionally, the incidence of hypotension, hypoxia, bronchospasm, and laryngospasm was similar between groups K, KF, and P (p > 0.05, for each) When subgroups of group 2 were compared, the duration of recovery was shorter in group D (p = 0.012). Hypotension, hypoxia, bronchospasm, and laryngospasm occurred similarly in both general anesthesia subgroups (p > 0.05). Conclusions: Deep sedation was associated with a significantly shorter duration of procedure and recovery compared with general anesthesia, without an increase in the incidence of periprocedural complications. © 2025 The Authors